2012 Residency App

St MinneSomePlace In Paradise

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2012 Residency App

Residency Application

2012 RESIDENCY APPLICATION

To claim your lone palm on the island of St. MinneSomePlace and reside among the many other crazy Parrots Heads on our quaint island, please complete the residency application below. For your convenience, there are three types of annual memberships: Adm, Active and Social.....see descriptions below. So decide how involved you want to be and join us down island!

St MinneSomePlace membership is $25 dollars for individuals
and $35 dollars per year for couples.

Memberships are for the calendar year.

After submitting this form you will be contacted confirming your residency.
Checks can be made out to St. MinneSomePlace and mailed to:

St MinneSomePlace in Paradise
PO Box 1201
Maple Grove, MN 55311-6201

Payment can be made by PayPal...see instructions below.

You may download and print the form:
Download and Print Blank Form

2012 Residency Application

If applying for more than one person, please select each person's membership preference, either Adm, Active, or Social.

NOTE: When your Application is complete, click on the "Phins Up" button to send your application to the Membership Bwana. You will receive a confirmation email shortly. You will be directed to the PayPal Page when you click on "Phins Up". If you've elected to pay by check, please just click out of the PayPal page.

In case you are wondering, this payment is not tax deductible as a charitable contribution for federal tax purposes. All other donations are tax deductible, as this funding is dedicated to community service efforts rather than operational expense of our organization.

DATE: *
Membership (1): *
Membership (2): *
First Name(1): *
Last Name(1): *
First Name (2):
Last Name (2):
Address Street: *
City: *
State: *
Zip Code: *	(5 digits)
Daytime Phone: *
Evening Phone: *
Email, Personal: *
Email, Business:
Email, Additional::
Permission to Share Email:
Occupation/Company:
Birthdate (MM/DD):
Age Group: *
Children, Ages:
How did you hear about St MSP:
What is your favorite Buffetism (saying, song, lyric, etc.):
Personal Interests and Hobbies:
What is your favorite Buffett/Parrot Head experience:
Payment: *

If you have any questions regarding this procedure, please contact HeadBwana