MEMBERSHIP APPLICATION 2007/2008

          NEW   (circle one)    RENEWAL

NAME___________________________________________

ADDRESS________________________________________

CITY_________________STATE___________ZIP_______

PHONE:(W)_________________(H)___________________

CATEGORY:

Patron____ ($150), Sponsor ____($80), Family ____($50)

Regular____($30), Student____($10).

We are a 501(C) organization (not for profit). Make checks payable to:

Florida Free Speech Forum, and mail to: P.O. Box 357104, Gainesville, Fl 32635.