Membership-Renewal Form

The American
Bonsai Society

VIRGINIA BONSAI SOCIETY - Application for Membership and Renewal

	Individual Family	Individual - $20.00/year
Date		Family - $25.00/year
Name(s)		After July pay half this amount.
Address:
City:		Make Check Payable to:
State:
Zip:		Virginia Bonsai Society
Telephone	EX: 757 123 4567	And Mail To:
E-mail		Stephen Krall 2804 Heritage Dr. Suffolk, VA 23435
Occupation
Hobbies
Do you give permission to include your Telephone Number, Email Address on a VBS List of members for distribution to members? Telephone E-Mail Address		NOTE! Membership or Membership Renewal does not go into effect until a check is received for payment.