Application First Name * Last Name * Nickname or Preferred Name Email Address * This will be your login user name Password * Please enter a password (up to 10 characters). Confirm Password * Confirm Password Birth Date This will not display in your directory profile. Spouse/Partner Name (optional) Name of Sponsor (if you have one) Contact Information Local Street Address Local City Local State AKALARAZCACOCTDCDEFLGAHIIAIDILINKSKYLAMAMDMEMIMNMOMSMTNCNDNENHNJNMNVNYOHOKORPARISCSDTNTXUTVAVTWAWIWVWY Local Zip Code Preferred Phone Number Cell Phone Number Alternate Phone Number Is Florida your legal residence? Yes No Alternate Contact Information If you have an alternate address, please check the box below. I have an alternate address Alternate Street Address Alternate City Alternate State/Province ABAKALARAZBCCACOCTDCDEFLGAHIIAIDILINKSKYLAMAMBMDMEMIMNMOMSMTNBNCNDNENHNJNLNMNSNTNU NVNYOHOKONORPAPEQC RISCSDSK TNTXUTVAVTWAWIWVWYYT Alternate Postal Code Alternate Country AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBosnia and HerzegovinaBotswanaBrazilBruneiBulgariaBurkina FasoBurundiCambodiaCameroonCanadaCape VerdeCayman IslandsCentral African RepublicChadChileChinaColombiaComorosCongoCosta RicaCôte d‘IvoireCroatiaCubaCyprusCzech RepublicDenmarkDjiboutiDominicaDominican RepublicEast TimorEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEthiopiaFijiFinlandFranceFrench GuianaFrench PolynesiaGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuamGuatemalaGuineaGuinea-BissauGuyanaHaitiHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsraelItalyJamaicaJapanJordanKazakhstanKenyaKiribatiNorth KoreaSouth KoreaKuwaitKyrgyzstanLaosLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacedoniaMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMauritaniaMauritiusMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew ZealandNicaraguaNigerNigeriaNorwayNorthern Mariana IslandsOmanPakistanPalauPalestinePanamaPapua New GuineaParaguayPeruPhilippinesPolandPortugalPuerto RicoQatarRomaniaRussiaRwandaSaint Kitts and NevisSaint LuciaSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbia and MontenegroSeychellesSierra LeoneSingaporeSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSpainSri LankaSudanSurinameSwazilandSwedenSwitzerlandSyriaTaiwanTajikistanTanzaniaThailandTogoTongaTrinidad and TobagoTunisiaTurkeyTurkmenistanTuvaluUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVatican CityVenezuelaVietnamVirgin Islands, BritishVirgin Islands, U.S.YemenZambiaZimbabwe Which is your preferred MAILING address? Local Address Alternate Address About You Which statement best describes you? I live in the Naples area full time (more than 10 months) I live in the Naples area 1-6 months a year I live in the Naples area 7-10 months a year What is your current employment status? I am retired I am working full-time I am working part-time Please let us know your hobbies and interests. Select all that apply. Hobbies and Interests Bridge, Cards Computers Cooking Crafts Foreign Affairs Gardening Golf Mah Jongg Painting/ Drawing/Visual Arts Photography Politics Reading Running Tennis Travel Walking Water Sports Writing Yoga OtherOther Education History Please list your three highest degrees from an accredited college or university. College or University Field of Study Degree AAASBABSJDMAMBAMDMPAMSMSWPhDOther Other Degree College or University Field of Study Degree AAASBABSJDMAMBAMDMPAMSMSWPhDOther Other Degree College or University Field of Study Degree AAASBABSJDMAMBAMDMPAMSMSWPhDOther Other Degree Career History Please share the three most recent positions you have held. Company or Organization (most recent) Position Held Company or Organization Position Held Company or Organization Position Held Based on your background or education, which best describe your skills? Select all that apply. Skills Finance Accounting Marketing / Public Relations Education and Training Fundraisings / Development IT, Computers Administrative / Clerical Food Service / Hospitality Project Management Legal Medical / Health Human Resources Nonprofit Management Editorial / Writing Art / Creative Design Interior Design Renovation Management OtherOther Local Nonprofit and Civic Experience What LOCAL organizations are you CURRENTLY involved in and what position do you hold? What LOCAL organizations have you belonged to in the past and what position did you hold? Nonprofit and Civic Experience Outside SWFL What organizations are you CURRENTLY involved in outside SWFL and what position do you hold? What organizations have you belonged to outside SWFL in the past and what position did you hold? Committee Sign Up If you are a new applicant please DO NOT fill this section out at this time. Once your membership is approved you will be asked to update your profile and sign up for a committee. Please proceed to the next section by hitting submit below. Please select ONE (minimum; TWO maximum) committee(s) for service during the upcoming year. Note: If applying for SUSTAINER status, please check the sustainer box in the list below before proceeding. Afternoon with Authors Archives (no members needed currently) Artisan Marketplace Arts & Culture Circle of Support Civic Engagement & Outreach Culinary Adventure Dining For Philanthropy Education (Scholarships) Empowering Women Empowering Women's Scholarships Luncheon Executive Committee (Officers only) Environment Flea Market General Federal of Women's Clubs Liaison (GFWC) Health & Wellness Hospitality Investment (by invitation only) Juniorettes Juniors (no members needed currently) Libraries Meeting & Event Decor Membership Passion for Fashion Tea Philanthropy (Sorry, this Committee is full) Photographer (Communications) Public Relations/Advertising (Communications) Providence House Shop & Share Events Social- Social Media (Communications) Sponsorships Treasury Committee Website (Communications) Sustainer Member: No Committee choice Make sure you have completed all the required fields, then click on SUBMIT or UPDATE to save your work and advance to the next screen. If you are applying for membership you hit SUBMIT and be directed to the application payment page. Website/URL If you are human, leave this field blank.
