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Puerto Rican Professional Association
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NEWS
APPLICATION
Fields marked with (*) are required.
First Name:
Mr.
Dr.
Miss.
Mrs.
Ms.
Prof.
*
Last Name:
*
Address:
*
City:
*
State:
*
Zip Code:
*
County:
--- Select ---
Brevard
Broward
Miami-Dade
Monroe
Orange
Osceola
Palm Beach
Seminole
Volusia
Other
*
Chapter:
South Florida Chapter
Central Chapter
*
Daytime Phone:
305
561
786
787
954
407
*
Evening Phone:
305
561
786
787
954
407
*
Fax Number:
305
561
786
787
954
407
e-Mail:
*
Occupation:
--- Select ---
ACCOUNTING
ADMINISTRATION - MANAGEMENT - HUMAN RESOURCES
AIRLINES
ADVERTISING - PUBLIC RELATIONS - PROMOTIONS
AMUSEMENT PARKS
ATTORNEYS - LEGAL
BANKS - FINANCIAL - MORTGAGES
BUSINESS OWNERS - SELF EMPLOYED - RETIRED
COMPUTERS - WEB - INFORMATION TECHNOLOGY
DENTISTS
EDUCATION
ENGINEERING - ARCHITECTURE
FLORISTS
FUNERAL AND CEMETERIES SERVICES
GOVERNMENT - LAW ENFORCEMENT
GRAPHICS - PRINTER
INSURANCE COMPANIES - AGENTS - SERVICES
MARKETING SERVICES
MEDICAL
MEDIA
MILITARY
PHARMACEUTICALS
PRIVATE INVESTIGATIONS
NON PROFIT ORGANIZATIONS
REAL ESTATE
SALES
TRANSPORTATION
*
Job Title:
*
Company/Organization:
*
Company Website:
http://
https://
Month/Day of Birth:
1
2
3
4
5
6
7
8
9
10
11
12
1
2
3
4
5
6
7
8
9
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11
12
13
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15
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17
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19
20
21
22
23
24
25
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27
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29
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31
*
Place of Birth:
*
Relation to Puerto Rico:
Born in PR
Grandparents
Parents
Other
Pay Method:
US Check
Credit or Debit Card (
read more
)
*
We accept all major credit and debit cards
Comments:
Upon receipt of your annual membership dues of $75, we will process your application.
Please remit payment in check to:
PROFESA
PO Box 524288, Miami, FL 33152