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Printable Membership Form

SAN FRANCISCO SEMINOLE CLUB
Membership Form

Name: ___________________________________               Date: __________________     
Address: ____________________________________
               ____________________________________

City: ____________________    State:_____   Zip: ___________

Home Phone: ______________________
Work Phone: _______________________
Email: _____________________________

Are you an FSU graduate?  _____ Yes   _____No   What Year & Major? _________________________

Would you be interested in serving on a committee? _____Yes   ______No
(Committees include: Events & Activities    Scholarship    Membership/Recruitment     Newsletter/Communication    Community Service    Public Relations)

Please indicate your interests/hobbies? ______________________________________________
__________________________________________________________________________________

Membership Type:
______ $20 Individual
______ $30 Family
______ Renewal  or  _______New Member
**Membership term lasts one year from the date your dues are paid.**

Please print, complete and return to:

San Francisco Seminole Club
P.O. Box  26742
San Francisco, CA 94126

Make checks payable to the San Francisco Seminole Club