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Donation Page

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Donation

* Mandatory fields

*Company Name

*First name-

First & Last name should be related to the email address used for this profile

*Nick Name

Sue; Tom; Chuck; Liz; etc

*Last name-

First & Last name should be related to the email address used for this profile

Suffix

Jr., Esq., CLS, CLC, etc

*e-Mail

Invalid email

This is your LOGIN for this site and should BELONG to the person entered in the First/Last name fields

This email is already in use.

*Street Address

Bldg Name/Apt./Suite

*City

*State

*Zip

*Phone

*FL COUNTY- YOUR Office

We use this info to make sure you are invited to meetings held in your area

*I primarily work for:

The MAIN office

A BRANCH office

in order to invite you to functions in your area, we need to KNOW the COUNTY where you work, and if your company has branches, which one relies on you the MOST.

Dietary restrictions

Clear selection

Yes

Gluten Allergy

Nut Allergy

Dairy Allergy

Vegetarian

Vegan

If this field is not answered, we will "assume" none.

*Which Fund

*Confirm Donation to FLTA Charitable Action Foundation, Inc

General Donation to FLTA Foundation

Donation to Scholarship Fund for Higher Education

Donation to Melodye Marvin Memorial Scholarship

*Confirm Contribution to Title Industry of Florida PAC

Contribution to TIFPAC

*Confirm Contribution to Agents' Section Lobby Fund

Contribution to ASLF

*Amount ($USD)

Other Amount is in invalid format

Corporate Platinum $10,000.00 (USD)

Corporate Diamond $7,500.00 (USD)

Corporate Gold $5,000.00 (USD)

Corporate Silver $2,500.00 (USD)

Corporate Bronze $1,000.00 (USD)

Individual Champion $5,000.00 (USD)

Individual Advocate $2,500.00 (USD)

Individual Partner $1,000.00 (USD)

Individual Supporter $500.00 (USD)

Individual Friend $250.00 (USD)

If choosing other, please specify corporate or individual in the comment box below.

Comment

Length limit exceeded.

If you prefer to use a check, please mail it to:
FLTA
P.O. Box 66145,
St. Pete Beach, FL 33736

Email: Executive Director, Scott Merritt
Email: Executive Assistant, Jena Daly

Email: Membership Engagement Coordinator, Rebecca Charette

Phone: 850-681-6422

Florida Land Title Association is a 501(c)6 not-for-profit organization.

Mailing Address:
Florida Land Title Association
P.O. Box 66145
St. Pete Beach, FL 33736