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 Membership Registration Form

Please print this page and fill out the information. Come in person to our meeting of the month if you pay cash.  If you would like to pay by cheque, please mail the completed form and your cheque to:

Ina Mechlinski,  20 Evergreen Ave., Tiny ON L0L 1P1

First Name________________________________________________

Last Name________________________________________________

Address__________________________________________________

Telefon Nr.___________________________

E-mail address:                                                                                        

Per Person $10.-              Amount sent:   __________

Date:                                       

Cash:          cheque:        Received:____________________________

Date and signature:        ____________________________________

                                        (for Elmvale & District Horticultural Society)

Last Updated: 2012-04-27