Personal Information |
| First Name*: |
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| Middle Name: |
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| Last Name*: |
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| PSM#: |
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| Telephone*: |
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| Address*: |
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| City*: |
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| State*: |
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| Zip Code*: |
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| County of Residence*: |
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| District*: |
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| Gender*: |
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| Date of Birth*: |
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| Email Address*: |
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Employer Information |
| Employer*: |
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| Employer LB#: |
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| Employer Address*: |
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| Employer City*: |
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| Employer State*: |
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| Employer Zip Code*: |
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| Work Phone: |
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| Fax Number: |
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| I
request membership materials and correspondence be mailed
to:
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May
we release this information to other organizations in the
surveying & mapping profession?
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SignatureI
certify that the statements made in this application are
true and correct and I agree that if admitted to membership,
I shall abide by the Constitution and By-Laws of the Florida
Surveying and Mapping Society and shall participate in
Society functions, programs and other endeavors, to uphold
the Society's principals and promote its objectives in
so far as within my power.
YES |
Sponsorship
(Sponsorship
required for Affiliate, Associate, Full, Retired and Student
Members)
I, the undersigned, being a full member
in good standing in the Florida Surveying and Mapping
Society, am personally knowledgeable of and believe this
applicant to be truly interested in furthering the profession
of surveying and mapping in the grade applied for, upholding
the Society's principles, promoting its objectives and
do hereby recommend for membership in the Florida Surveying
and Mapping Society.
YES
PSM#:
Full Name:
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Membership Grades |
State Dues |
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FULL MEMBER - Florida licensed Surveyor and Mapper in good standing
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$232.00
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ASSOCIATE MEMBER - Any person employed in the field of Surveying & Mapping
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$82.00
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AFFILIATE MEMBER - Any person in a profession/business closely associated with surveying or mapping or licensed in another state or territory of the United States
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$82.00
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RETIRED MEMBER - any person retired from the surveying profession
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$82.00
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STUDENT MEMBER - Any full-time or part-time student
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$0.00
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SUSTAINING FIRM - Any business related to surveying and/or mapping profession
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$257.00
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STATE DUES
Annual dues for any person
admitted to membership in the Society for the
first year or portion thereof, shall be charged
on a prorated quarterly basis from the date of
the application in accordance with the Society's
fiscal year. Please call the Administration office
for more information.
The Omnibus Budget
Reconciliation Act of 1993 requires associations
to inform their members of the amount of dues
used for lobbying and political purposes. This
lobbying amount is not deductible by you as a
business expense on you personal or business
tax return. Of your dues payment, 31.37 percent
is used by The Florida Surveying and Mapping
Society, Inc., for lobbying and helps protect
your right to practice as a surveyor and mapper.
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| Select
Membership Grade:
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Chapter Dues
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Full |
Associate
or Affiliate |
Sustaining
Firm |
| Broward County |
$35.00 |
$20.00 |
$35.00 |
| Central Florida |
$30.00 |
$20.00 |
$30.00 |
| Charlotte-Harbor |
$25.00 |
$10.00 |
$25.00 |
| Chipola Area |
$25.00 |
$20.00 |
$25.00 |
| Collier-Lee |
$20.00 |
$10.00 |
$20.00 |
| Emerald Coast |
$20.00 |
$10.00 |
$20.00 |
| FAU Geomatics Engineering Student Chapter |
$0.00 |
$0.00 |
$0.00 |
| Florida Crown |
$30.00 |
$15.00 |
$30.00 |
| Geomatics Student Association |
$0.00 |
$0.00 |
$0.00 |
| Gulf Coast |
$25.00 |
$10.00 |
$25.00 |
| Indian River |
$25.00 |
$15.00 |
$25.00 |
| Manasota |
$40.00 |
$20.00 |
$35.00 |
| Miami-Dade County |
$50.00 |
$20.00 |
$50.00 |
| North Central Florida |
$35.00 |
$0.00 |
$35.00 |
| Northwest Florida |
$20.00 |
$0.00 |
$20.00 |
| Palm Beach |
$50.00 |
$25.00 |
$50.00 |
| Panhandle |
$40.00 |
$10.00 |
$40.00 |
| Ridge |
$25.00 |
$0.00 |
$25.00 |
| Space Coast |
$25.00 |
$0.00 |
$25.00 |
| Tampa Bay & West Central |
$40.00 |
$20.00 |
$40.00 |
| Volusia County |
$30.00 |
$10.00 |
$30.00 |
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| Select Chapter*: |
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Voluntary Contributions |
| Disaster Relief Fund: |
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| Scholarship Foundation: |
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| FL GPS Users' Group Dues: |
($25.00) |
Online Payment |
| Please click "Calculate Total" to calculate the total amount of your dues. (Student Memberships have no dues; simply press "Submit" below.) |
| Total: $0.00 |
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| Credit Card Number: |
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| Expiration Date: |
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Name on Card
(First Name): |
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Name on Card
(Last Name): |
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| Billing Address: |
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| Billing City: |
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| Billing State: |
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| Billing Zip: |
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