NAME OF MEMBER ASSOCIATION
Membership Application/ Renewal
Website or Facebook page of your association

$ AMOUNT OF DUES (Individuals and/or Families)
Monthly member meetings are held:
Day of the week each month
Time
Meeting site address

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____ New membership _____ Renewal ______ Family $ _______ Individual $________

PLEASE PRINT

Name:______________________________________________________

Address:____________________________________________________

City:_______________________ State: Zipcode:_______

Phone: ( ) ________________________________

Email:______________________________________________________________

Membership / Renewal application and dues may be paid at a regular member meeting, or mailed to:

Name of Beekeeping Assn.
c/o Treasurer (List name)
mailing address

You may want to add the benefits of membership, i.e. members receive the monthly email newsletter, participation at all MEMBER ASSN. activities, etc.

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For Treasurer
Date Paid____________ ______ Check # Cash________ Paypal________