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TALLAHASSEE "100" CLUB
Post
Office Box 5989
Tallahassee, FL
32314
APPLICATION FOR MEMBERSHIP
Applicant's
Name ______________________________ Called ___________________________
Birthday ( Month/Day ) ______________ Spouse Name (if applicable) ____________________ Company Name ______________________________________ Position ____________________ Company Address _________________________________________________________________
City _____________________ State _______ Zip _______
Business Category ______________________________Nature
of Business _____________________________________________________________Business Phone _______________ Fax ________________ Home __________________
Business Web Site _______________________________________________________
E-mail ( please print ) ____________________________________________________
Home Address _____________________________________________________________City __________________________ State _______ Zip _______
Applicants must first be approved by the Club's Board
of Directors, then by the Membership at large. Fully approved applicants will be invited by the Club President to join.
An Application Fee of $60.00 plus the pro-rata share of annual dues must be paid. Then, as a new member in good standing,
you will be entitled to attend Club luncheons, dinners and social events. (Note: the pro-rata share shall be based
on the remaining months in the year, starting from the month of Club approval.)Annual dues are $450.00, which covers the Club lunches, dinners and 3-4 social events for the member and spouse or
special guest.Please return this form with Application
Fee to the above address.Applicant's Signature
______________________________________________________
Date ________________________ Applicant's Sponsor ________________________ Co-Sponsor ________________________Sponsor's Comments ___________________________________________________________
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