Annual Membership form

Please enroll me in the membership category specified: full time student $15.00 individual $25.00 family $40.00 contributor $100.00 donor $250.00 patron $500.00 lifetime $1,000.00

Name
Address
City
State Zip Code

email

Payment method:
Check Make checks payable to: Georgeson Botanical Garden Society
Charge: VISA MasterCard
Card number + 3 digit extension:
Cardholder name:

Signature:_______________________________________________

Expiration date:

Please send me information on:
the Garden volunteer program
Garden donation program (honor a friend, relative, business by donating funds for benches, plants, sundial, land scape materials, gazebo, etc. All donations are recognized in the garden.