
METHODIST FEDERATION FOR SOCIAL ACTION
Florida Chapter
2008 Membership Form
Name(s) Date
Mailing Address
City State Zip
Home Phone Work Phone Cell Phone__
E-mail Address
Check the Appropriate Membership Category:
Household ($75) Individual ($50) Student (low income) $25
Specify up to three social concerns about which you feel passionately and which you would be willing to work with other MFSA members to address:
(1)
(2)
(3)
Make checks payable to Florida MFSA and mail to: Robert Thomason, Membership Secretary
2 Ocean Dune Circle
Palm Coast, FL 32137
(386) 446-8066
rthomason@cfl.rr.com
Dues are divided between the Florida Chapter and National MFSA as follows: Household (60/15); Individual (40/10); and Student (low income) (20/5)