The World Affairs Council
of the
Florida Palm Beaches
Membership Application
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Please provide the following information and we will sign you up for membership.

Title:  
First Name:
Last Name:
Spouse Name:  
Company:    
Address:    
City:           
State:  
Zip:  
Phone:     
Email Address:  
I wish to join the Young Professionals Group.
Type of Annual Membership Desired
Form to load one line of events table Form to load one line of events table Form to load one line of events table Form to load one line of events table Form to load one line of events table
Diplomat.................. $5000 Presidential.............. $5000
Statesman................. $2500 Ambassador................ $1000
Benefactor................ $600 Patron.................... $400
Community Sponsor..... $600 Family.................... $200
Individual................ $125 Student................... $10

Mail membership dues along with a copy of your confirmation Email to: World Affairs Council of the Florida Palm Beaches, 150 Banyan Isle Drive, Palm Beach Gardens, FL 33418-4601

 The Council is a non-profit, 501(c)(3), corporation so donations and dues may be tax deductible to you or your corporation.  



FORM # ADMIN/NEWMEMFORM

World Affairs Council of the Florida Palm Beaches