All information on this application will be for

 South Coast Plumeria Society's use only

It will not be sold, shared or used for any other purpose.

New (  )   Renewing (  )

Name_________________________________________

 Significant other__________________________________

Address___________________________________________

City ___________________________________

State _____ Zip + 4____________-________

Phone _________________________________

Email__________________________@_____________________

(newsletters are published via email in an Adobe .pdf format for those with internet access)

Dues are due at the first meeting of each year and are as follows:

[  ] Newsletter subscription $5.00(no membership privledges, newsletter only) 

[  ] Regular Membership $15.00(all membership privledges plus newsletter) 

[  ] Household Membership $20.00(two at the same address, all membership privledges plus newsletter)  

[  ] Commercial Membership $50.00(includes newsletter, membership privledges and a business card size advertisement in each newsletter) 

RETURN THIS FORM WITH YOUR DUES

South Coast Plumeria Society

P O Box 4138 Seal Beach CA 90740