Membership or Event Form

Middleburg Civic Association

ESTABLISHED IN 1941
IN HISTORIC MIDDLEBURG, FLORIDA

Physical Address: 2102 Palmetto St. . Middleburg, FL 32068
Mailing Address: P.O. Box 147 Middleburg, FL 32050
Phone: 904-282-3150
Your invited to join us !!!!!
Print - Complete - Return
Contact Information:

Name:
_______________________________________________________
Business Name:
_______________________________________________________
Home/Business Address:
________________________________________________________
Home/Business Phone Number: _______________________________
E-mail Address:
________________________________________________________
Membership Level Requested
Family $15.00_____ Business $25.00_______ Event Sponsor $_________

Event Registration

       Easter Eggstravaganza & Antique Car Show March 27, 2010 10am-3pm:
Vendor Set-up & Car Line-up at 8:30am
Crafters Member/$10.00____Non-Member $25/Non-Profit: $10.00  ___
Autos/ truck $10.00 __
          Independence Day Parade : July 3, 2010 9AM Line-up @ First Baptist Church @ 8:00am
  Member/Non-Member$20.00------- /Non-profit $10.00 ____    Political Entry: $50:00 _______
         Historic Fall Festival: November 6, 2010 10am -3pmVendor Set-up at 8:30am
   Member: $10.00_____   Non-Member: $25.00 ____ Non-Profit: $10.00___
        Lighted Christmas Parade:  Dec 11th 6:30 P.M. Line-up at First Baptist Church at 5:30pm
   Member/non member $20.00__ Non-profit $10.00__Political $50.00

If you wish to receive a fax confirmation fax copy to 282-9210
provide Ph#______________ for fax back