Peninsula Orchid Society Membership Application

Mail to: Rene Biggs
Peninsula Orchid Society
P. O. Box 6894
San Mateo, CA 94403-6894
Type of Membership: New ______ Renewal ______
Individual ________ $20.00 Additional Member same household________ $10.00
Senior ________ $14.00 Additional Member same household________ $10.00
Business ________ $26.00
Name(s) (1) __________________________________________________ Birthdate ______________
(2) __________________________________________________ Birthdate ______________
Address __________________________________________________
City __________________________________________________
State __________________________________________________
Phone __________________________________________________
E-mail (1) __________________________________________________
(2) __________________________________________________
Please mark the items listed that you may be interested in:
___ Volunteering___ Becoming a Board Member
___ Being a Meeting Speaker___ Giving a Skill Session
___ Help with setting up meeting___ Helping with meeting take down/clean up
___ Helping at the Member's sales table at meeting
 
Comments/Suggestions:
 
 

To be completed by Membership Chairperson:
Date Paid________________ Given a directory:________________
Check No.________________ Check Amount________________
Receipt No.________________ Cash Amount________________
Notes: