Renewal Form

MICKEY’S “FAN”ATICS 2025 RENEWAL FORM(Renewal ended do not use )
(Read carefully) Please complete the form below (one form per member) by typing the information, then print on 8 1/2 x 11 sheet of paper.
Mail form(s) along with $15 per person to:
Mickey’s “Fan”atics , ℅ Dottie Contos ,
1990 Lake Ridge Drive , The Villages FL 32162.
Make checks payable to Mickey’s “Fan”atics.
Dottie Contos must receive the form(s) and money by DEC. 1, 2024. Any form received after this date will not be accepted for renewal.

Name *

First

Last

Email *

Home Phone Number *

Cell Phone Number *

Address *

Line 1

Line 2

City

State

Zip Code

Country

Thank You!