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Membership Application
Please
print out this form, write in CAPITAL letters and send with payment to
the treasurer.
I would like to
join the American Primrose Society:Name:____________________________________________________ Address: Street or Box_________________________________________________ City ________________________________________________________ State/Province _____________________Zip Code/Postal Code______________ Country_____________ Telephone_________________________Fax___________________E-Mail_______________________ (Please check one) Annual Membership______ ($25.USA & Canada / $32.Overseas, in US currency) Three Years Membership_____($70.USA & Canada / $90.Overseas, in US currency) Lifetime - Individual______($350.in US currency) (Please check one) Cheque payable to American Primrose Society ______ Money order payable to American Primrose Society _____ Please charge to my VISA credit card _____ Mastercard______ Name on the card:______________________Signature___________________________ Number______________________________Exp.date______________ Amount enclosed: $___________ Please send this application form to: Jon Kawaguchi, APS Treasurer 3524 Bowman Ct. Alameda, Calif. 94502 How did you hear about the American Primrose Society? |