Georgia Botanical Society
Membership Application
 

Please print and mail this form to:

GEORGIA BOTANICAL SOCIETY
C/O Anita Reaves
2718 Stillwater Lake Lane
Marietta GA 30066

Make your check payable to: Georgia Botanical Society

Contact Information: 770-827-5186, email members@gabotsoc.org

Please check here if you are a member of the Coastal Plain Native Plant Society: _____

Please check here if you like to be a member of the Coastal Plain Chapter of the Georgia Botanical Society: _____

 

Name _________________________________ Spouse __________________________________

Address _______________________________

             _______________________________

 

City __________________________________ State _________ Zip ___________
Phone (home) __________________________ Phone (work) __________________
E-Mail Address ________________________
Membership Classes:

Individual or Family

 $25.00 Donor $100.00
Group $30.00 Lifetime $350.00
Student $10.00 Patron $1000.00