ASSOCIATE MEMBERSHIP APPLICATION

Name _________________________ Phone ___________________

Postal Mailing Address __________________________________________

City __________________________ State _______ Zip ____________

Preferred e-mail address ________________________________

Please answer the following Associate Club membership application questions.

1. Have you been a regular Club member in good standing for at least 12 months (yes/no ____)

AND

Terminated employment prior to normal retirement age ( yes / no )

OR

Are ineligible for Regular Club membership as an employee of another company because of a membership ratio limit being met. ( yes / no )

2. Have you read and understand the Clubs By-Laws as they pertain to Associate Club Membership as posted on the Club's web site? (http://floridapowerclub.com) ( yes / no )
3. Have you read and understand the Club's 'Ticket Policy' as posted on the Club's web site? ( yes / no )

5. Using the table below, have you enclosed a check payable to the Florida Power Club with your application? ( yes / no )

If the current month is	Please Remit
February	$33.00
March	$30.00
April	$27.00
May	$24.00
June	$21.00
July	$18.00
August	$15.00
September	$12.00
October	$9.00
November	$6.00
December	$3.00
January	$36.00

Please mail your application to:

FLORIDA POWER CLUB
P.O. BOX 13356
ST. PETERSBURG, FL 33733
ATTN: Lynn Taylor PEB7