* = Required Fields
Name:
*
Title:
Representing:
Municipality   County   State   Federal   Other  



Mailing Address:
Address:
*
City:
*
State:
*
Zip:
*



Phone:
Fax:
Email:
*



Years in current position:

Years in Governmental fleet operation:

Total number of years in fleet operations:



Type of application: New   Renewal   Regular   Associate   Affiliate  

Membership Dues: Sending in mail   Will pay at next conference  




Regular Members: Governmental employees whose primary responsibilities include administration and/or management of fleet operations – Annual Dues $50
Associate Members: Governmental employees whose responsibilities are directly related to and/or support fleet operations – Annual Dues $50
Affiliate Members: All others who wish to support the Association, including those who provide goods and services to fleets – Annual Dues $80
Honorary Members: Regular, Associate, and Affiliate members who have retired in good standing and are approved by the general membership – No Annual Dues



Please provide all information requested above and return with your Annual Dues in check or money order payable to FLAGFA. Mail to: Ralph Tack, Southwest Florida Water Mgmt. District, Fleet Services, 2379 Broad Street, Brooksville, FL 34604
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