MCAN Member Application

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Please fill out this short form. A payment link will be provided taking you to Flanzer Trust Organization (for payment) once you click submit. The fee for Membership in 2022 is $75.00. Welcome to the Manatee County Aging Network Team!

Email *

Are you a New Member *

Yes

Are you a Renewing Member *

Yes

Name of Business *

Street Address of Business *

City and State of Business *

Zip Code of Business *

First and Last Name of the Contact Person for the Business *

Phone Number of the Contact Person for the Business *

Member First and Last Name *

Member Email *

Individual Member? *

Yes

Business Member? *

Yes

Brief Description of the Business *

What type of guest speakers/information are you interested in learning more about? *

What industry related topics are most important to you? *

What type of activities do you want to see more of/less of? *

Are you interested in a Board Position? *

Yes

Have you served on a Board or Committee previously? *

Yes

Are you interested in joining a Committee? *

Fundraising Committee

Grant Writing Committee

Speakers

IT/Website

Outreach/Marketing

DCCI Manatee

Not at this time

When you click Submit a message will come up with the link to the donation webpage. Click on the link and please select "Manatee County Aging Network Donation" in the drop down menu.

Option 1

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