FLORIDA ORIENTEERING
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


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