MEMBERSHIP APPLICATION
The Hernando Chapter of the Florida Native Plant Society

Name ________________________________________________________

Company _____________________________________________________

Address _____________________________________________________

City ________________________________________________________

State _______________________________________________________

Phone (___)__________________________________________________

Category: (please check one)

__ Individual $25.00
__ Family or household $30.00
__ Contributing $40.00
__ Not-for-profit organization $50.00
__ Business or corporation $100.00
__ Full time student $15.00
__ Newsletter subscription $15.00
__ Supporting $100.00
__ Donor $250.00


Please make check payable to:
The Florida Native Plant Society
P.O. Box 6116
Spring Hill, FL 34611
(813) 856-8202

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