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UF Medical Guild Membership Application Form
Overview

UF Medical Guild Membership Application Form

Membership is from May 1st through April 30th. Dues are payable on May 1st. If you are a new member, your membership fee is waived during your first year. Please complete, then submit this form.

Original Entry Date:

MM slash DD slash YYYY

Membership Type(Required)

New

Renewal (Active)

Honorary

Inactive

Referred by (if new member)

Your Name(Required)

Prefix First Last

Your Address(Required)

Street Address Address Line 2 City State ZIP Code

Subdivision (if local)

Your Present or Past Occupation

Your Email Address(Required)

Email Address Confirm Email Address

Your Preferred Phone(Required)

Birth Month and Date(Required)

Spouse/Partner's Name

Prefix First Last

My Spouse/Partner is

Working

Retired

Deceased

Consent(Required)

I agree to support the UF Medical Guild’s mission to promote friendship among the members and to provide philanthropic support to UF Health and the communities it serves.

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Date of 2025 Dues Payment(Required)

MM slash DD slash YYYY

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Payment made by:(Required)

Check

Online

N/A

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Amount(Required)

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Check Number:

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Date of 2025-26 The Guild Gives Gift

MM slash DD slash YYYY

CAPTCHA

UF Medical Guild, Inc.

Physical Address: PO Box 142246
Gainesville, FL 32614
Email: ufmedguild@gmail.com

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