Membership Application

(Renewals – Just correct the mailing label on the other side)

Name: __________________________

Address: __________________________

City, State, Zip: ___________________________

Telephone : ____________________________

E-mail: ___________________________

Month of your Birthday______________

Do you want a name tag? YES _________ NO____________

Would you be willing to work on a committee or other capacity? Yes_________ No_______________

Membership Dues are:

$15 per year for individuals

$20 per year for more than one member at the same address

Please make check payable to Bromeliad Society of Broward County and mail this page to:

Bill Frazel, Treasurer

Bromeliad Society of Broward County

P.O. Box 551152

Where we meet: Broward County Extension Education

Division

3245 College Avenue - Davie, Fl

33314-7719

Phone: 954-370-3725 ext. 252

Fax: 954-370-3737