Application

Membership Application

To apply for (or renew) membership in The Florida Park Service Alumni Association, please complete the following information.

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Personal History Information:

NAME:_____________________________________________________________

ADDRESS:__________________________________________________________

CITY:  ______________________________STATE:  _____________ZIP:  _____________

TELEPHONE: (HOME)____________________ (WORK)_____________________________

Cell Phone___________________________

(Email)_________________________________________________

Current or past section, district or park where service performed with the Division of Recreation and Parks:

 

If spouse of Division of Recreation and Parks employee:

Give employee name________________________________ years service______

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Membership Request (check one of the following)

(    ) REGULAR MEMBER – Current, retired or past Division of Recreation & Parks employee who has attained permanent status employment. Spouse of current, retired or past Division employee who is or was previously in a permanent status. Annual dues are $15.00.

(    ) ASSOCIATE MEMBER – Any individual, not otherwise eligible for membership, including OPS and Volunteers who have demonstrated a commitment to the objectives of the Florida Park Service.  Annual dues are $15.00

(    ) PARTNER MEMBERSHIP – Businesses or organizations who support the mission of the Association or the Florida Park Service and whose membership is approved by the Board.    Annual dues are $50.00

(    ) LIFETIME MEMBER – Regular member who has paid a lump sum equivalent of 20 years of annual dues ($300) in advance. Spouses, widows, and widowers of Regular Members are also eligible.

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Send the completed application along with a check made out to Florida Park Service Alumni Association, Inc., for annual membership dues to:

Judi Maxwell, FPSAA Secretary
558 S.W. Maxwell Court
Fort White, Florida 32038
(386) 497-4750