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Long Island Bonsai Society
Membership
Long Island Bonsai Society Membership Application
     
Name (Please Print)    
     
Address:    
City:    
State:    
Zip:
     
Phone:    
     
Email:    
     
Please check the appropriate membership level:  
  [   ]  Individual - $40.00  
  [   ]  Couple - $45.00  
  [   ]  Student - $10.00  
  [   ]  Supporting - $50.00  
  [   ]  Newsletter Only - $7.00  
     
     

Please contact: Jim Stopfer our club's membership secretary at jim.stopfer@gmail.com   for more information.