GPPA Application for Membership

I (We) wish to join (renew our membership in) the Georgia Perennial Plant Association.

Date: __________________________ Type of Application: ___ Renewal ___ New Membership
(Individual or Business Membership) Name 1: __________________________
(Dual or Business Membership) Name 2: __________________________
(Business Membership Only) Business Name: __________________________
Address: __________________________
City: __________________________
State: __________________________
9-digit Zip Code: __________________________
Home Phone with Area Code: __________________________
Work Phone with Area Code: __________________________
E-Mail: __________________________
Check the type of membership below:  

__ Individual Membership $35/yr
__ Dual Membership (2 adults at same residence) $50/yr
__ Business (2 designated individuals from one business) $65/yr

Number of Memberships: ___ at $____ per membership per year
Tax deductible donation to GPPA: $________
Total enclosed: $________
Check Number:  _________

For more details, contact any GPPA Board Member.
Dues are due annually between October 1st and January 31st for the calendar (Jan-Dec) year.
Memberships run from January 1st through December 31st.

Please mail this completed form and your check to:

   P.O. Box 13425
   Atlanta, GA 30324-0425
   Attn: Membership