Monterey Bay Dahlia Society 2009 Membership Form

Please fill out the form, write check, and mail to:

Membership

Monterey Bay Dahlia Society

P.O. Box 812

Soquel, CA  95073

Name(s)_____________________________________________________________________________________

Address______________________________________________________________________________________

_____________________________________________________________________________________________

Phone_(________)________________ Birth Dates of each member (not the year!)______________________

Email__________________________________________________

                                                                                                                                                CHECK BOX

There  are 2 MBDS memberships: 

1)   single/family with email newsletter--------------------------$10/year

2)   single/family with mailed hardcopy newsletter------------- $16/year

$______________

If you also want to join the National Society, Add on:

Optional American Dahlia Society Membership:    Single $20/YR $_______________

 (includes quarterly ADS Publication and Annual Classification Book)           Family $23/YR $_______________

       Membership Total $_______________                                                

Optional Monterey Bay Dahlia Society Personal Name Tag - $6 per member

Name(s) as you want to appear________________________________________________________________________

Number of Name Tags________ X $6 $_____________

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(To be filled in by MBDS Membership Committee) Date Received:__________________

Amount Submitted: Local:$___________ ADS:$___________ Name Tags:$__________ Total:$___________

Changes Submitted to: Newsletter Editor______ President:_______ Name Tag ordered__________