Connecticut Botanical Society membership application

Print out this form and mail it to:

CBS
P.O. Box 9004
New Haven, CT 06532
 
Name(s)____________________________________________
 
Address____________________________________________
  
 ____________________________________________
  
 ____________________________________________
  
Phone (optional)____________________________________________
 
E-mail (optional)____________________________________________

If this is a gift membership, please provide your name:

____________________________________________

Please select a membership category and make the check payable to
the Connecticut Botanical Society. Dues for membership are:

Regular
$15.00 individual, $20.00 couple

Contributing
$30.00 individual or couple

Sustaining
$40.00 individual or couple

Supporting
$50.00 individual or couple

Life
$300.00 individual, $500.00 couple

The membership year is the calendar year. New members joining after September 1 will be credited for the coming year.

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