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The Hundred Club of St. Lucie County
Membership Application

Please Fill out the Application and Print and Mail to the Addres Below
Date:	Jan 07, 2009
Name:	(first)	(middle)	(last)
Company:
Mailing Address:
City:
State:
Postal Code:

Email:

New Membership
	Life Membership - $1500 (One ticket to annual meeting/banquet and one vote)
	Corporate Membership - $250 (Two tickets to annual meeting/banquet and two votes)
	Individual Membership - $100 (One ticket to annual meeting/banquet and one vote)
	Law Enforcement / Firefighter Membership - $50 (One ticket to annual meeting/banquet and one vote)

Renewal Membership
	Corporate Membership - $250 (Two tickets to annual meeting/banquet and two votes)
	Individual Membership - $100 (One ticket to annual meeting/banquet and one vote)
	Law Enforcement / Firefighter Membership - $50 (One ticket to annual meeting/banquet and one vote)

Please mail check and application to:
The Hundred Club of St. Lucie County c/o Tammy Schwab, St. Lucie County Sheriff’s Office 4700 West Midway Road Fort Pierce, FL 34981


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Under Florida law, e-mail addresses are public records. If you do not want your e-mail address released in response to a public-records request, do not send electronic mail to this entity. Instead, contact this office by phone or in writing.
38.103.63.62	Copyright © 2009St. Lucie County Sheriff's Office. All rights reserved.		Jan 07, 2009 6:43