Florida Assisted Living Coalition has defined itself as a leader in providing healthcare education to the professional community - we offer most programs free or at our basic cost making learning easy and affordable. Rival conferences charge hundreds of dollars yet at Florida Assisted Living Coalition one can anticipate spending no more than $69.00 with early registration for 12 Continuing Education Credits, include most meals and cover most disciplines from Guardianship, Nursing, Social Work, Physical/Occupational therapy,  and insurance agent CE's. Besides being a source for learning we are also a valuable source for referral. We provide social service outreach to seniors and the disabled throughout Florida. 

Membership is meaningful when you realize benefits fostered by professional wealth of knowledge and personal wealth of relationship building and referral.

Membership Application
Email to: nina.plonka@cgsi.cc

Membership Director

Nina Plonka

APPLICATION: 

Member Name: ___________________________________________________

Company: ________________________________________________

Address: _________________________________________________

City/State/Zip: ____________________________________________

Office Telephone: ____________________ Fax: _________________

Cell : ____________________Web Site: _______________________

Title: _____________________________________________________

Email Address: _____________________________________________

The membership administrator will verify each applicant to ensure that they meet the criteria identified in becoming a member. As a member of this organization you should plan to attend several meetings a year, including our annual conference. Our membership is all about leadership, restoring faith in the referral network and helping your fellow members who help you in your objectives. Membership value is high, but so should your commitment to giving back to the community. Remember life is a full circle.

Underscore the committee you want to try to participate;

•  Planned Giving
• Membership
• Newsletter/Press Release
• Conference A) Education B) Trade Show C) Conference General
• Regional Meeting Speakers Bureau
• Web Site Design/Update
• President’s Elite
• Community Outreach
• Community Partner
  We help you to maximize your business potential

1. Would you like your business profiled in an upcoming FALC e-Newsletter? ______________
2. Name at least 2 organizations you are also a member of or have been a member in the pat 3-5 years? ______________________________________________________________
3. Underscore the type of Membership you are interested in General or Associate or Community Partner.
4. Underscore, yes or no, if you would like to save 20% off your total cost of membership by enrolling in a two year plan.
5. Annual dues will conclude 14 months from the date your check is received, not the date on your application or on your check.
6. If you are qualified to become a member, please send dues to Attn: Nina Plonka, along with your  Membership Application.

Make your Check Payable

NPF - Chapter (Parkinsons)

Mail Membership Payment: Florida Assisted Living Coalition

FALC, 2500 N. Federal Hwy., Suite #202, Fort Lauderdale, FL 33305

I authorize FALC to use my photograph for membership media purposes. I recognize that as a member I agree to participate in periodic programs to benefit my own business or company that I am affiliated. I recognize that I may be photographed and my photo will be used for organization development usage.

Signature of Applicant __________________________________ Date ___________________________

Verified by –  Nina Plonka Membership Director: ________________________________       

Date ________________