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MEMBERSHIP APPLICATION

HOW DO I BECOME A MEMBER?  Membership in GOC are available to same gender couples aged 18 and above for a fee of only $40.00 per couple for the next 12 months.  Membership entitles couples to attend all GOC functions for 1 year; to receive monthly GOC newsletters and quarterly national newsletters; to hold a valid GOC membership card; to vote, hold office and participate in GOC Business meetings; to receive preferred rates at GOC sponsored events that are open to the general community; and future benefits yet to be determined. 

Send your check for $40.00 (payable to GREATER ORLANDO COUPLES) and this form completely filled out to:  GREATER ORLANDO COUPLES;   P.O. BOX 4338;    WINTER PARK, FL  32793-4338

NAME:___________________________________  (Nickname): ___________________ DOB (MM/DD): __________________

NAME: __________________________________   (Nickname): ___________________ DOB (MM/DD): __________________

MAILING ADDRESS: __________________________________________________________________________________

CITY: ____________________________________   STATE:  _____________________  ZIP: ________________________

EMAIL:______________________________________________   (whose: ___________________________________)

EMAIL: ______________________________________________  (whose: ___________________________________)

PHONE: ______________________________ ANNIVERSAY: (mm/dd/yy)____________________________________

SIGNATURE: ___________________________________________  DATE: __________________________________

SIGNATURE: ___________________________________________  REFERRED BY: __________________________

INCLUDE US IN THE MEMBERS CONFIDENTIAL DIRECTORY?                         _________ Yes     __________No

PICTURE RELEASE:  Allow your pictures in Newsletter and/or on the Web Site:    _________ Yes    __________ No

NEWSLETTER FORMAT:  

______________ Want mailed copy  & emailed copy   OR   ___________ email only