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Monterey Bay Dahlia Society 2007 Membership Form

It is time to renew!! The information we are collecting is critical to the smooth operation of the club. Some of the information may have already been submitted, however, we are trying to develop a useful list and have some gaps, so please help us by filling in all the spaces.

If you joined and paid your dues for MBDS or the American Dahlia Society after September 1st you will not need to renew you dues again until December 2007. This is a one-time extension for late season new members.

Please bring to the next meeting or mail to:

Jean Biberdorf, Membership/Treasurer

Monterey Bay Dahlia Society

2038 Ellen Avenue

San Jose, CA 95125

Print very clearly and return to Jean Biberdorf

ARE THERE ANY CHANGES IN THE FOLLOWING INFORMATION SINCE LAST YEAR? New email, etc?? YES NO

 

Name(s)_____________________________________________________________________________________

 

Address______________________________________________________________________________________

_____________________________________________________________________________________________

 

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

 

Email__________________________________________________

Membership Type: Single Monterey Bay Dahlia Society $10/YR $______________

Family Monterey Bay Dahlia Society $10/YR $______________

Optional American Dahlia Society Membership: Single $23/YR $_______________

(includes quarterly ADS Publication and Annual Classification Book) Family $26/YR $_______________

Membership Total $_______________

OPTIONAL: Would you prefer to receive your newsletter via Email? ________YES ________NO

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__________