FLORIDA EMERGENCY PREPAREDNESS ASSOCIATION
400 Capital Circle SE, ST 18-263
Tallahassee, FL 32301
850-274-1835
www.fepa.org
FLORIDA EMERGENCY PREPAREDNESS ASSOCIATION
2016 MEMBERSHIP RENEWAL FORM
Dear Member:
Thank you for your continuing support of FEPA and its programs. Please complete this
renewal form for your 2016 FEPA membership dues. Annual Membership dues for the
2016 calendar year are $100.00 per person. Student membership dues are $25.00 per
person.
MEMBERSHIP RENEWAL FORM:
Please provide us with your membership information:
Name:
Title:
Company:
Address:
City:
Work Phone:
Email Address:
FEPA Area:
State:
Zip Code:
To pay using Mastercard/Visa/American Express write the account information and
expiration date below then email to erainey@fepa.org or mail to the address above.
Card # ________________________________
Expiration date ___/____
Security Code: ________ Name as Appears on Card: ___________________
Billing Address of Card: __________________________________________
City: ____________________ State: ______________ Zip: _____________
Pay online at http://www.fepa.org/
Make check payable to:
Florida Emergency Preparedness Association, Inc.
Federal ID # 59-2389989
400 Capital Circle, SE ST-18-263
Tallahassee, Florida 32301
THANK YOU FOR YOUR SUPPORT!