Application for
Membership
100 Black Women of Funeral Service, Inc.
Attn: Membership Services Dept.
P.O. Box 2652
Orlando, Florida 32802-2652
407-595-9277
407-774-7456
407-774-0588 (FAX)
HundredBWFS@aol.com
Website: www.100BlackWomenofFuneral Service.com/100bwfs/home.htm
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Name:______________________________________________________________
Home Address:_______________________________________________________
City /
State /
Zip:______________________________________________________
Email Address:_______________________________________________________
Business Affiliation:____________________________________________________
Business Address:_____________________________________________________
City /
State /
Zip:______________________________________________________
Telephone: B/H ______________________________________________________
City /
State /
Zip: _____________________________________________________
Cell Phone:_________________________________________________________
_____Renewal Membership or New Membership - $130.00
_____Student Intern Membership - $30.00
_____Mortuary Science Student - NO FEE if enrolled in a Funeral Service Program
_____Corporate or Mortuary School Membership - $295.00 (1 - 4) Staff Members
Please attach a current
resume and recent photograph that includes education
affiliations & work history that will be shared with the Public Relations
Department.
Applications will not be complete until received.
_________________________________________________________________
_____ I pledge to uphold the high standards of the Mortuary Profession.
_____ I pledge to encourage new memberships and promote mentoring.
_____ I have enclosed my current photo-bio or resume and my firm
history.
_____ I have enclosed a check/money order/or cashiers check for
membership.
_____ I am enrolled in a certified Funeral Service/Mortuary Science Program.
Signature:____________________________________________________
Date:_________________________________________________________