Huron Valley Chapter - Membership

Huron Valley Chapter, Michigan Botanical Club
Membership year runs from January 1 - December 31

Please print out this form and mail to the address at the bottom.

Name(s) ______________________________________________________________

Address ______________________________________________________________

City________________________________     State__________________________

Zip code/postal code ___________________  COUNTRY ________________

Home Phone________________________  Cell Phone ________________________


New Member ______        Renewal ________

Which version of the state newsletter and HVC newsletter would you prefer:

_____Electronic (in color)     _____Paper     _____Both

Do you wish to be notified of events by email?  ____ yes   ____ no
Do you wish to be notified of events by telephone?  ____ yes    ____no
Do you wish to have this information published in our membership directory? ___ yes  ___ no
(Membership directory to be distributed to all members of HVC)

Sustaining membership dues    $40.00 (or more in U.S. funds)
Regular membership dues        $30.00 (U.S.funds)
Student membership dues        $20.00 (U.S.funds)

If you are a student please give the name of your college _________________________

Please make check payable to: Michigan Botanical Club-Huron Valley Chapter.

Send this form with check to: Toni Spears, Treasurer
Huron Valley Chapter
Michigan Botanical Club
7412 Black Forest Dr
Dexter  MI  48130