Fill out the form on this page, then click the Print button to generate a completed application which you can print and mail in. Or, just print this page and fill out with pen or pencil.
Florida Native Plant Society
MEMBERSHIP APPLICATION
Please type or print block letters
First Name
Last Name
Business or Organization (optional)
Address
City
State
Zip+4
FL. County
Home Phone
Cell Phone
Work Phone
Fax
E-mail
Chapter
Assigned by location unless otherwise specified
Yes!
Sign me up for the
FNPS Action Alert e-mail list.
Select Membership category
If this is a gift, enter giver information: Name
Membership #
Life $1000
Donor $250
Business $125
Supporting $100
Contributing $75
Non-profit $50
Family/Household $50
Renewing Individual $35
Student $15
Library $15
Additional Contributions
$
General Fund
,
educational and other activites.
$
Endowment Fund
,
native plant research projects.
$
Total
Amount Enclosed
Payment
Check/MO
Visa
MC
Discover
Check/Money Order#
Please do not mail cash.
Make payable to
FNPS
.
Credit Card#
-
-
-
Exp. Date
3-digit CV code on back
Name on Card:
Billing address & zip code if different from above:
Florida Native Plant Society
INFORMATION SURVEY
Please help us build a stronger organization by completing this survey.
Thank you!
We need your help!
Please check if you can contribute.
Expertise/Interests
(Check all that apply)
Advocacy
Art/Photography
Education
Event Planning
Field Trips
FNPS Leadership
Fundraising
Government Policy
Gardening/Landscape Design
Growing Plants
Master Gardener/Master Naturalist
Membership Development
Plant Surveys
Publications/Writing
Public Speaking
Volunteer Coordination
Profession
Accountant
Attorney
Botanist/Ecologist
Educator
Elected Official
Graphic Designer
Land Manager
Landscape Architect/Designer
Municipal Planner
Naturalist
Nursery
Please mail survey & membership application to:
FNPS
PO Box 278
Melbourne, FL 32902-0278
Credit card payments can be faxed to 815-361-9166