AMERICAN FLORAL INDUSTRY ASSOCIATION.doc

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					                               AMERICAN FLORAL INDUSTRY ASSOCIATION
                                        P. O. BOX 420244 DALLAS, TX 75342-0244
                                      Phone: 214.742.2747 Fax: 214.742.2648
                                     EMAIL: rpoling@afia.net WEBSITE: www.afia.net

                                    2010 MEMBERSHIP APPLICATION
COMPANY: ____________________________________________________________________________________
CONTACT PERSON: _____________________________________________________________________________
MAILING ADDRESS: ______________________________ C/S/Z:_________________________________________
COUNTRY: ___________________ E-MAIL: __________________________________________________________
PHONE: __________________________________________FAX: ___________________________________________
WEBSITE: _______________________________________________________________________________________

Please make check payable to:                               American Floral Industry Association
                                                            P.O. Box 420244
                                                            Dallas, TX 75342
Or complete credit card information and fax to:             214.742.2648

CREDIT CARD: M/C VISA  AMEX  DISCOVER
CARD #__________________________________________
NAME ON CARD: _________________________________EXPIRATION DATE: _________________
AUTHORIZING SIGNATURE: ___________________________________________________________
                                 TYPE OF BUSINESS: (CHECK ALL THAT APPLY)
 IMPORTER         MANUFACTURER  GROWER  RETAILER                          WHOLESALER  OTHER: ________

                                  ANNUAL MEMBERSHIP DUES INVESTMENT
                     PLEASE CHECK YOUR APPROPRIATE MEMBERSHIP CATEGORY BELOW:
 REGULAR MEMBERSHIP                                                                                        $500
Regular Members are voting members of the American Floral Industry Association and shall consist of any individual,
firm, company, partnership, limited-liability corporation or any other type of business entity that demonstrates
warehousing, distribution and sales of botanical, holiday and/or seasonal products and accessories in North America.
Regular Membership enjoys full benefits including delegated seats on the Board and trade show discounts, if applicable.

 AFFILIATE MEMBERSHIP                                                                                      $250
Affiliate Members are non-voting members of the American Floral Industry Association and shall consist of any
individual or legal entity interested in our industry. This membership includes but is not limited to wholesalers, retailers
and news media sources doing business in our product categories or providing services to the industry. Non-Exhibiting
member and does not qualify for show space discount.
  *I hereby certify that the information provided is true and accurate to the best of my knowledge and understand that my
                                        membership classification is subject to approval.
Signature: _________________________________Title: __________________________ Date: __________
              *Mail this form with your payment OR FAX this form with your credit card information
                                            TO THE AFIA OFFICE*
                                                FAX 214.742.2648

				
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