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The Florida Association of Legal Videographers, Inc.

Post Office Box 17048, Clearwater FL 33762-0048
Office Phone/ Facsimile 727-539-7511

Profession Products/Services Application

Name: ______________________________________________________________________

Company Name: ______________________________________________________________

Mailing Address: ____________________________________________________________

City/State/Zip _______________________________________________________________

web site __________________________________________________________

Business Phone: ( ) ___________________________

Fax: ( ) ___________________________

E-Mail Address: ________________________________

Type of Business, service, supplies, etc. ____________________________________________

_______________________________________________________________________________________

 

_______________________________________________________________________________________

please attach copy of classified advertisement (text Only) to be listed on web site,

I, _____________________________________, Have Enclosed a Check or Money Order

NAME

(Made payable to The Florida Association of Legal Videographers, Inc) In The Amount of $24.00 For a six month advertising fee. Please forward payment to the above address.