Southeast Chapter, Michigan Botanical Club
Membership year runs from
January 1 to December 31
 Please print out this form and mail to the
address at the bottom.
On
the lines below, please make any corrections needed from the mailing label.
Name ____________________________________________________
Address __________________________________________________
City ______________________________________________________
State _____________________ Zip code (plus 4) or postal code ___________
COUNTRY _________________________
Office Phone ______________________ Home Phone
______________________
Email address ____________________________________ (will
not be printed or distributed)
Do you wish to have you phone number published in our membership
directory? ____ yes ______ no
| Individual membership: |
$20.00 (U.S. funds) |
|
Family membership* : |
$20.00 (U.S. funds) |
| Benefactor: |
$30.0O (U.S. funds) |
* A family membership is for two or more adults at same address
Dues
include subscription to the journal Michigan Botanist, the state
newsletter Arisaema, and the Southeastern Chapter Newsletter
Please make check payable to: Michigan Botanical
Club-SEC
| Send this form with check to: |
Richard Fowler, Treasurer
2045 McIntosh Drive
Troy, MI 48098-2238
Phone: (248) 828-2952
|
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