Membership Application
Mr. Mrs. Ms. First Name: _____________________Last Name: ____________________
Mailing Address: ________________________________________________________
City: ____________________State: _____ Phone # ____________________________
Email: _________________ D.O.B. / Age. _______ Occupation: ___________________
Company Name: ___________________________________________________ Please check the following boxes for areas of interest:
___ Interested in The Lime in-town after work events? ___ Dancing.___ Dining.___ Mix & ingle. ___ Interested in The Lime day trips?___ Shopping.___ Beach/Fishing.____ Horseback riding. ___ Sightseeing.___ Museums.___ Sports/concert events. ___ Other: __________________________________.
___ Interested in The Lime out of town Vacations.___ Miami.___ Orlando.___ Naples.___ Sebring. ___ Tampa.___ Arcadia. ___ Fort Lauderdale. ___Clearwater.___ Daytona. ___ Florida Keys. ___ Las Vegas.___ Peru.___ St. Croix.___ Cruises. ___ Other: __________________________.
___ Interested in The Lime Co-Ed Sports events?___Valley ball.___ Soft Ball.___ Golf. ___Tennis. ___ Other: ___________________________.
___$29 Basic. ___$49 Silver. ___$75 Gold. ___$99 Platinum. ___$299 Event Planning Service. Referred by: __________________________________________________ ___ PayPal confirmation #_____________ ___ Check #_____________ ___ Cash $____________ Make Checks payable to: The Lime P.O. Box 6876 Avon Park, FL. 33826-6876 |