MEMBERSHIP APPLICATION
MAKE CHECKS PAYABLE TO: FLO
MAIL TO: FLO, c/o Mike Dempsey
655 Little Wekiva Rd
Altamonte Springs, FL 32714
PLEASE PRINT ALL INFORMATION LEGIBLY
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FLORIDA ORIENTEERING
MEMBERSHIP APPLICATION MAKE CHECKS PAYABLE TO: FLO
PLEASE PRINT ALL INFORMATION LEGIBLY |
NEW MEMBER [ ] RENEWAL [ ] DATE _________________
MEMBERSHIP DUES PER YEAR: INDIVIDUAL $10 [ ] COUPLE $15 [ ] FAMILY $20 [ ]
LIFETIME: INDIVIDUAL $150 [ ] COUPLE $225 [ ] FAMILY $300 [ ]
NAME _______________________________________________________________________ YEAR OF BIRTH ________
STREET _______________________________________________________________________ APARTMENT # __________
CITY __________________________________ STATE ____________ ZIP __________ COUNTY _______________
PHONE (_____)____________________________
CELL (_____)____________________________ E-MAIL ADDRESS _____________________________________________
OCCUPATION _____________________________ OUSA MEMBER? YES [ ] NO [ ] OUSA MEMBER # _______________
Florida Orienteering is a non-profit organization affiliated with OrienteeringUSA (previously the United States Orienteering Federation - USOF) and
created to serve the interests of orienteers in Florida. FLO was established to promote the sport of Orienteering and to increase environmental
awareness in the state of Florida. These purposes are served through the sponsorship of orienteering events in the state and the production of
recreational orienteering maps. Your membership directly supports these activities.
As a member, you may enter FLO events at a reduced rate, and are entitled to membership OrienteeringUSA at a reduced rate. (See the OUSA
Membership Application for specific details.) We will encourage and request your participation in event organization, map making, course setting
etc., as these activities are vital parts of orienteering that are as much fun and challenge as competition.
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ADDITIONAL MEMBERSHIP INFORMATION
IF FAMILY (or COUPLE) MEMBERSHIP, PLEASE LIST OTHER MEMBERS BELOW:
NAME SEX YEAR BORN NAME SEX YEAR BORN
1. ______________________________ ___ _____ 4. ______________________________ ___ _____
2. ______________________________ ___ _____ 5. ______________________________ ___ _____
3. ______________________________ ___ _____ 6. ______________________________ ___ _____
WHERE DID YOU HEAR ABOUT FLORIDA ORIENTEERING? ________________________________________________
IF A FLO MEMBER INVITED YOU, PLEASE PROVIDE THEIR NAME ________________________________________________
PLEASE INDICATE AREAS IN WHICH YOU WOULD LIKE TO ASSIST AT FLO EVENTS:
Registration __ Start __ Finish __ Control Retrieval __ Event Location(s) __________________________
You may choose to make a contribution in addition to your FLO membership dues in order to promote special projects, operating costs, or our
mapping efforts in Florida. Your valued support is greatly appreciated!
DONATED AMOUNT ____________ THANK YOU!!!
MembershipApplication.doc 01-08-2012