Application for membership to TBRUG:
| Company: | |||||
| Address: | |||||
| City: | State: | Zip: | |||
| Phone: | |||||
| Name: | |||||
| Title: | |||||
| EMail: | |||||
| Name: | |||||
| Title: | |||||
| EMail: | |||||
The sum of $_____ is enclosed, payable by
check or money order (no cash) to: TBRUG, for ____ individual
membership(s). Corporate memberships are not available,
individual memberships are non-transferable.
Cost of membership is $10 per person.
Meeting Registration Form:
| Name: | Member: | Yes / No | |||
| Name: | Member: | Yes / No | |||
| Name: | Member: | Yes / No | |||
| Name: | Member: | Yes / No | |||
| Company: | Phone: | ||||
| Amount Enclosed: | |||||
Method of payment (Please check one):
____ Check (Made payable to: TBRUG)
____ Money Order (Made payable to: TBRUG)
____ American Express (Fill out the following information)
Card Number __________________________________ Exp. Date:
___________
Phone Number
_____________________________________________________
Name as it appears on card: ___________________________________________
Authorized Signature: ________________________________________________
| Mail to: | TBRUG PO Box 3424 Clearwater, FL 33767 |