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Personal Details
Name
E-mail
City
Type of Membership
Membership
Silent Partner
New Member
Renewal
Membership Application
P.O Box 98
Belleview, Fl. 34421
Address
Address
State
Zip
Phone
Birth MM/DD
Dues
Annual Dues
Student -------- $5.00
Adult ------------ $10.00
Family ---------- $15.00
Sponsor -------- $25.00
Memorial ------- $50.00
Benefactor ------ $75.00
I would like to be an active member by helping with Book Preparation
Yes
No
Please fill out the application and mail to
Friends of Belleview Library
P.O Box 98
Belleview, Fl. 34421
Amount Enclosed
Benefactors - Name or Company will be displayed on a VIP list in the Library
Memorials - Name of donor and the deceased will be displayed on a plaque in the Library
Silent Partner - If you want to become a member but don't want to get involved
Instructions
Membership Information
