Amusement Machine Owners Association of Florida, Inc. www.amoaf.com

635 Beville Rd 386-232-8773

South Daytona, FL  32119  info@amoaf.com

Membership Application/Renewal

Primary Contact Name

Secondary Contact Name                                                                

Business Name                                                        

Address #1                                                                        

Address #2                                                                

City/State/Zip                                                                

Email1                                        

Email2                                                

Phone                                        

Fax                                        

Best Phone number for emergencies/texts                                

Business membership info – please indicate by circling type and activity:        

General Member        Focus: street, arcade/fun center, bowling, __________(other)        

Associate Member         Manufacturer, distributor, supplier, __________(other)

Are you a member of AMOA?                Yes        No

DUES: $1 a day, $365 per year.  Membership expires 12/31/2017.

Please make checks payable to:

Amusement Machine Owners Association of Florida

635 Beville Rd.

South Daytona, FL  32119  

Amount due:        New Member                        $365.00

                Renewing Member                $365.00