FBM Application

Fraternal Benefit Membership

Welcome! You are joining a unique organization of Polish-Americans. Established more than 125 years ago, Polish Falcons of America has provided for the physical, social and financial welfare of its Members. Our mission is to promote, develop and maintain our Polish heritage through social, cultural, educational and physical activities; to provide benefits for our Members through life insurance and annuities, and establish in the U.S. and other countries subordinate chapters called Nests. All Members belong to a Nest. Countless families from all walks of life have benefited from their Membership in our Polish fraternal benefit society and physical fitness organization, and by doing so, strengthen the Polish-American Community.

Polish Falcons is a not-for-profit organization. When you join Polish Falcons of America, you also become part of the larger Polish community in the United States. As a not-for-profit organization, we serve a higher purpose. Polish Falcons provides a wide range of benefits, programs and activities for our Members and the community.

Supporting the Polish-American Community. Since its founding in the United States, Polish Falcons of America has been an integral part of the Polish-American Community. Through those years, PFA Members have supported one another and the communities in which they live. We honor our heritage both in the United States and Poland. New Members are welcome to our organization to help support our mission.

Our Bond. According to the PFA Constitution and Bylaws, the bond of our Membership is: persons who are of good moral character, who by birth or descent are of Polish or Slavic nationality, and their husbands or wives regardless of nationality, or any individual who is judged supportive of the purpose and ethnic heritage of the Polish Falcons of America.

Statement of Polish Falcons Common Bond.
I am age 21 or older and am applying for Fraternal Benefit Membership with Polish Falcons of America.

To apply for Membership, please fill out the form below.

Fraternal Benefit Membership Application

Full Name(Required)

First Middle Last

This application is recommended by (if applicable)

Billing Address(Required)

Billing address must match credit card statement.

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Mailing Address

Please complete if different from billing address.

Street Address Address Line 2 City State / Province / Region ZIP / Postal Code Country

Phone(Required)

Email(Required)

Date of Birth

Sex(Required)

Male

Female

I wish to join Nest #

If you are not sure which Nest you wish to join, leave this blank and you will be assigned to the National Headquarters Nest.

Please select one of the following:(Required)

Please check:(Required)

I agree to support and further the mission of the Polish Falcons of America, pay my Nest and Fraternal Benefit Member Dues, and verify that the information I provided is true and correct.

Fraternal Benefit Member Dues ($40 per year)

Price:

Please note that dues auto-renew annually until cancelled. To cancel your Membership, please call 800-535-2071 or email info@polishfalcons.org.

Total

Credit Card

American Express

Discover

MasterCard

Visa

Card Number

Expiration Date

Security Code Cardholder Name

Fraternal Benefit Membership Application

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