Please complete all items below , print this form, and mail it with a check to:
     Mrs. Elsie Mueller
     1847 34th Avenue, Box WWW
     San Francisco, CA 94122-4019

Level of membership:
Single ($50)
Single, Two Years ($90)
Joint ($65)
Joint, Two Years ($120)
International ($50)
Student ($25)
Business ($90)

Sustaining ($125)
Supporting ($250)
Life, individual ($600)
Life, Joint ($800)
Endowment, includes Life Membership ($1,000)

Add $4 if you wish 1st Class mailing for Bulletin.

The California Horticultural Society prints a biennial Roster listing its members and their gardening interests to facilitate inter-member contact between those with similar interests (ie. shade gardening, daffodils etc). This Roster is to be used solely for member contact and not for mailing lists, advertisments etc. Check here if you do not wish your contact info and gardening interests printed in our Roster.

JOINT MEMBERSHIPS ONLY:
Second member's name (first and last):

Street address:

City, State and Zip:

Home telephone:

Work telephone:

Fax:

E-mail:

Gardening interests: