Discount Directory Application

Click here to download a printable PDF version of the form.

Please return this form via email to or mail to:

1770 San Marco Rd., Suite 204
Marco Island, Fl 34145

Please call Ruth McCann at 642-7778 should you have any questions.

Please inform MICA in writing of any changes (location, telephone number or withdraw) to your listing.

Yes, I wish to participate in the MICA “Members only Discount Program.”

    Mailing Address (If different from business address)