2017 and Beyond Membership & Contribution Form
TYPE IN OR PRINT
each section, print the completed form. Either mail it, or bring it to a Membership Meeting.
The POA - P.O. Box 386 - Oxford, FL 34484
Number of People in Household
(We respect your privacy: your E-mail address is for POA official use only)
( Check Year(s) of your Choice )
One Year - 2017 = $10 per Household
Two Year - 2017/2018 = $20 per Household
Three Year - 2017/2018/2019 = $30 per Household
ADDITIONAL CONTRIBUTION IF DESIRED:
TOTAL AMOUNT FOR DUES AND CONTRIBUTION:
I will include a stamped, self-addressed envelope with this form and my check. Please mail my Membership Card to me.
Please hold my Membership Card for me to pick up at one of the monthly POA meetings.
THANK YOU FOR YOUR SUPPORT AND CONTRIBUTION TO THE POA