Allied
MembershipApplication
FloridaRestaurantLodgingAssociation
Sales Volume Category Annual Dues Amount Due
$ 5,000,000 or more
□
$ 595
___________ NOTE: As an allied member, you
are entitled to a single membership in
Less than $5,000,000
□
$ 500
___________ FRLA and in one local chapter. You
Additional offices, chapters or
□
$
110 each X number
may add sales reps/offices and/or join
___________ additional local chapters for $110 each
sales representatives # ______
FRLA PAC Contribution* $ 25 $ 25*_______
Educational Foundation Contribution* $ 25 $ 25*_______
TOTAL DUES PAYMENT: ____________
* If you do not wish to participate in either supporting the industry politically or supporting its future leaders, you may decline the FRLA
PAC and Educational Foundation fees of $25 each.
As a paid allied member of FRLA, you are entitled to a FREE listings in the FRLA Online Buyers Guide. To ensure
that your business is properly listed, please list your three (3) most appropriate products/services below or contact the
membership department toll-free at 888-372-9119.
My Products/Services (for Buyers Guide):_____
____________________________________________________________________
BUSINESS NAME: _______________________________________________________ FRANCHISE/CHAIN? YES ______ NO ________
A
DDRESS: _______________________________________ CITY: ___________________________ STATE: _______ ZIP: ________
B
ILLING ADDRESS: (IF DIFFERENT)__________________________________________ CITY: ___________________________
S
TATE: _______ ZIP: ________
C
ONTACT NAME: _________________________________________ TITLE: _____________________________________________
C
ONTACT’S PRIMARY EMAIL ADDRESS: ____________________________________________________________________________
B
USINESS PHONE: _______________________________________ BUSINESS FAX: _______________________________________
C
ELL PHONE: ______________________________________ WEB ADDRESS: ____________________________________
C
ORPORATE NAME (IF APPLICABLE): _______________________________________________________________________________
F
ACEBOOK PAGE_________________________________________ TWITTER HANDLE______________________________________
G
OOGLE + PAGE______________________________________ PREFERRED LANGUAGE ___________________________________
T
HIS MEMBERSHIP SOLICITED BY: _____________________________
PLEASE TURN OVER TO CHOOSE YOUR FRLA CHAPTER AFFILIATION
METHOD OF PAYMENT (CHECK ONE): □ CHECK □ AMERICAN EXPRESS □ VISA □ MASTERCARD □ DISCOVER/NOVUS
CARD NUMBER: ______________________________________________________________________________________________
E
XP. DATE: ____________ SIGNATURE: __________________________________________________________________________
I (we) wish to affiliate with other professional hospitality leaders in Florida to receive the membership benefits of the Florida Restaurant & Lodging Association. I (we) pledge
to the Florida Restaurant & Lodging Association that this establishment will operate according to the Code of Ethics of the FRLA. I (we) have enclosed the correct annual
dues amount corresponding to the gross sales of my company, as indicated on the dues investment calculation form above.
SIGNATURE: __________________________________ PRINT NAME: ______________________________ DATE: _______________
PERMISSION STATEMENT: By providing your information, you agree to receive members-only communications, as well as partner information from the FRLA, including
but not limited to emails, direct mail and mobile notifications. DEDUCTIBILITY: Dues are not tax deductible as charitable contributions but may be deducted as ordinary and
necessary business expense. If you join FRLA, 75% of your dues is not deductible as business expense as a result of FRLA lobbying activity.
PLEASE REMIT DUES TO: FRLA, P.O. BOX 1779, TALLAHASSEE, FL 32302-1779 or FAX to
850-224-1590. Join online at www.frla.org/membership/join
Rev. Oct-17
ANNUAL DUES INVESTMENT CALCULATION
MEMBER INFORMATION
PAYMENT INFORMATION
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