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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. Then print this page (use File>Print or Ctrl+P), sign this form, and pay your dues by:

  • Using PayPal - Simply click this button: , select your desired Membership Type (from the drop-down list) and click Add to Cart. It is not necessary to have a PayPal account to use PayPal to pay your membership dues. You must also mail your printed membership application to the address below.
                                                                              OR
  • Mailing 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 and printed membership application to:

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

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): *
 

After the Treasurer has received your check and signed Membership Application 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.

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

  STOP!


Before you press

the "Submit" button,

print this page,

(use File>Print or Ctrl+P)

sign it and mail with your

dues payment (if not paying

with PayPal).
Submit Instructions

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

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