Tampa Bay Parrot Heads in Paradise Club!

 

“Let’s Leave the World a Little Better Than we Found IT…

And Have a Blast Doin’ It!”

 

MEMBERSHIP APPLICATION/RENEWAL FORM

(Three OUTS and you’re IN!  Print Out, Fill Out and Mail Out to the address below.)

 

Date:  __________________                     Amount Enclosed:  $________________

 

PLEASE CHECK THE APPROPRIATE BOX:  New Member (  )  Renewal (  )

 

Name:  ___________________________________________________________

 

Address:  _________________________________________________________

 

City, State:  ___________________________________   Zip:  _____________

 

Home Phone:  (      )_____________    Alternate Phone:  (      )_____________

 

Date of Birth (Month & Day):  ___________________________

 

Occupation:  _______________________________________________________

 

New Members - We’d appreciate if you’d also fill out the following:

 

How Did You Hear About Us?  _________________________________________

 

Favorite Buffett Song:  ______________________________________________

 

Talents You Can Contribute:  __________________________________________

 

 

ANNUAL MEMBERSHIP DUES:

 

$20.00

 

PLEASE MAKE CHECKS PAYABLE TO:

 

“TAMPA BAY PARROT HEADS CLUB”

PO BOX 41343 – ST PETERSBURG FL 33743-1343

 

PAYMENT OF DUES IS NOT DEDUCTIBLE AS A CHARITABLE CONTRIBUTION FOR FEDERAL INCOME TAX PURPOSES.

  

CONGRATULATIONS!  YOU’RE NOW A MEMBER OF THE GREATEST CLUB IN THE WORLD!!! 

 

GET INVOLVED – VOLUNTEER – MAKE NEW FRIENDS!

THANKS AND WELCOME TO THE PARTY