Check Membership type:     __ New        __ Renewal
   Individual __ One Year $25 __ Two Years $48 __ Three Years $70
   Family       __ One Year $35 __ Two Years $68 __ Three Years $100

*Overpayment of dues will be considered a donation to the club. MBS is a non-profit organization under 501(3) (C)

Please PRINT:

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Name(s)

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Address

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City

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State                                                  Zip Code

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Home Phone with Area Code

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Daytime Phone with Area Code

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Email  -  and/or  -  Fax Number

This information will not be published or otherwise distributed to the public and is for the use of MBS Board members only.

Please make your check or money order payable to:  Milwaukee Bonsai Society.

Mail to:
                     Milwaukee Bonsai Society
                     P.O. Box 240822
                     Milwaukee, WI  53224

MBS membership applications are also accepted at monthly meetings, to which the public is always invited.