American Rhododendron Society Membership Application Form

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Membership Application (Print and Mail)

Print out, fill in the form below and mail along with a check ($US) to:
American Rhododendron Society
P.O. Box 525 Niagara Falls, NY 14304

The form can also be faxed to: 905-262-1999

Name:
Affiliation / Second Name:
Street Address:
City:
State/Province:		Zip/Postal Code:
Telephone:
Fax:
E-Mail Address:
Confidentiality? (See note below)	Yes		No
Chapter:
Membership Category: (list below)

Membership Category	Yearly Dues ($US)
Individual	$35.00
Family	$40.00
Commercial-Corporate	$90.00
Sustaining	$50.00
Sponsoring	$100.00
Life	$1,000.00

Note: Confidentiality - May we have permission to use this information in our membership roster and other Society publications? All members' addresses appear in our membership roster, but checking "No" will avoid showing your phone, fax and E-mail address.

Thank you for joining the American Rhododendron Society!