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Logo IBM South Florida
Quarter Century Club
and Alumni Association

Membership Application



IBM South Florida QCC & Alumni Association
Membership Application

Annual membership dues are $20.00 (or $100 for a Lifetime Membership (Florida resident)/ $75(non-Florida resident))   

Please complete this application online by typing the required information into each box. Fields followed by an asterisk (*) are required. 

Last Name: *  

First Name: *        Middle Initial:   

Spouse/ Other Name:

Prime Area:
(e.g. Engineering, Manufacturing, etc.)


Years of Service (whole number):   *  

Membership Type:  *

Address:

City:       State:    5-digit Zip Code:  

Phone:           ( )        Cell:      ()

E-Mail Address: *
 

E-Mail (Verify): *
 

By submitting this application for membership, you are releasing the officers, members, and agents from liability in case of accident, injury or misadventure in connection with Association activities. Please review the Bylaws on this website for more information.



Signature

Your membership has not been submitted until you see the
"Your Membership Information has been submitted" screen.

To Pay Your Dues:
  • Use PayPal (PayPal account not needed) - Simply click this button: , select your desired Membership Type (from the drop-down list) and click Add to Cart.
                                                                              OR
  • Mail a check for the appropriate amount made out to "IBM South Florida QCC and Alumni Association" or "IBMSFQCCAA". In the memo area, write "Annual Dues" or "Lifetime Membership", as appropriate. Mail your check to:

    IBMSFQCCAA
    P. O. Box 273284
    Boca Raton, FL 33427-3284

After the Treasurer has received your PayPal payment or check you will receive an email containing a Login UserID and Password to access our Membership Directory page where you may view a list of current Association members and update your personal information online.

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