Membership Form - Panama Canal Society, Inc. | Social Nonprofit in Odessa, FL

MEMBER: (Select and complete all that apply)

Descendent/Dependent of

CZ Employee – Retired Date

US Government Employee

SPOUSE: (Select and complete all that apply)

Spouse Descendent/Dependent of

Spouse CZ Employee – Retired Date

Spouse US Military Service

Spouse US Government Employee

PCS Sponsor Address/Phone #

Eligibility for Membership ONLY REQUIRED FOR 1st time Applicant OR Renewing Inactive Member

Please SELECT payment type for appropriate membership ‐ Applicants must be 18 years old or older.

Renewal Membership for CURRENT MEMBERS when PAID BEFORE January 31st of current year.

Price: $40.00

Renewal for Inactive and 1st time Eligible Membership includes $10 admin fee if NOT paid before January 31st.

Price: $50.00

Governor’s Club Membership – 5‐year membership includes special benefits and a one‐time gift package.

Price: $200.00

Renewal Membership for CURRENT ASSOCIATE MEMBERS when PAID BEFORE January 31st of current year.

Price: $50.00

Renewal for Inactive and 1st time Associate Membership includes $10 admin fee if NOT paid before January 31st.

Price: $60.00

Governor’s Club Associate Membership – 5 year membership includes special benefits and a one‐time gift package.

Price: $250.00

PANAMA CANAL SOCIETY, INC. MEMBERSHIP APPLICATION