Huron Valley Chapter, Michigan Botanical Club
Membership year runs from January 1 - December 31
 Please print out this form and mail to the
address at the bottom.
Name(s)
______________________________________________________________
Address
______________________________________________________________
______________________________________________________________
City________________________________
State__________________________
Zip code/postal code ___________________ COUNTRY
________________
Office Phone________________________ Home Phone
________________________
email__________________________________
Fax ___________________________________
New Member
______ Renewal ________
Do you wish to be notified of events by email?
____ yes ____ no
Do you wish to be notified of events by telephone? ____ yes
____no
Do you wish to have this information published in our membership
directory? ___ yes ___ no
(Membership directory to be distributed to all members of HVC)
Sustaining membership dues $40.00 (or more in U.S.
funds)
Regular membership dues $30.00 (U.S.funds)
Student membership dues $20.00 (U.S.funds)
If you are a student please give the name of
your college _________________________
Please make check payable to:
Michigan Botanical Club-Huron Valley Chapter.
| Send this form with check to: |
Michigan Botanical Club
3437 Charing Cross
Ann Arbor MI 48108
|
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