Tangerine Improvement Society Membership Application
Membership Types:
Individuals $15.00 - Households $30.00 - Home Owner Association/Business:$75.00
Payable to: T.I.S.
Mail application to: P.O. Box 161 Tangerine Florida, 32777-0106

Name(s): ______________________________________________________________

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Birthday(s): ____________________________________________________________

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Home Phone: _________________________Cell Phone: _________________________

Email #1: _______________________________________________________________

Email #2: _______________________________________________________________

Physical address: ________________________________________________________

_________________________________________________________

Mailing Address: ________________________________________________________

_________________________________________________________

Business: ______________________________________________________________

Business Phone: _________________________________________________________

Are you a year round resident? Yes: ____ No: ____
If no, please tell us your other address and phone

Address: ____________________________________________________

Phone: ____________________________________________________

OK to print in Member Directory? Yes: ____ No: ____

New Membership ____ Membership Renewal ____

Please make checks payable to TIS Thank you!

(Please note: Membership dues are renewed annually based on the calendar year, however,
should you join TIS in the last quarter of the year, your membership will carry
through the following year.)