BCF, Inc. Membership Information Form

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Please take a moment to complete the information below. If you are paying dues for multiple persons only one check or money order is needed, but we request that each person has a completed form for informational purposes.

Name *

Email *

Mailing Address (include city and zip code) *

Home Phone number (include area code)

Cellphone number (include area code)

Age *

Gender *

Male

Female

Required

Please check all that apply *

I was born in the Bland Community.

My ancestors were born in the Bland Community.

My husband/wife was born in the Bland Community.

My husband’s/wife’s ancestors were born in the Bland Community.

I have lived in the Bland Community for at least five (5) consecutive years.

I have been an Associate Member of Bland Community Families, Inc. for three (3) years.

Required

Pay your dues!

Annual Membership Dues period is July 1-June 30. The dues structure is as follows:
Ages 12-17: $15.00
Ages 18-65: $20.00
Ages 66-70: $15.00
Ages 71 and above-Honorary free. (in order to qualify for Honorary this person must have been an Active Member prior to turning 71)

Please check how you have/will pay dues. *

I will/have paid my dues via check and mailed to PO 26 Alachua, FL 32626

I will/have paid my dues online using this link http://bit.ly/bcfmembership

I will/have paid my dues via Cash App $BCFINC1977

Required

This information will help with networking and career building within BCF

Please complete all that apply. If this doesn't apply to you you do not have to complete these.

Occupation. Also list if you own a business.

School you attended/are attending

Degree

Classification/Grade

Major/intended major

Additional Comments/Questions/Also add your business name and business contact info

Submit

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