Florida Gourd Society, Inc.
Membership Form

FLORIDA GOURD SOCIETY, Inc. annual dues are $12.00.
The renewal date is March 1st for all members.
New members prorated at $1 per month until the following March 1st
Please print, fill out the form, and mail along with your dues to:   
 

Therese Zamoiski

8501 Rock Knoll Dr

Jacksonville, FL  32221-6552

Make checks payable to:  Florida Gourd Society, Inc.

New ___     Renewal ___     Change ___     Correction ___

Name: ___________________________________________

Address:  _________________________________________

City/state/zip: _____________________________________

E-mail:  ______________________ Phone:  _____________

Patch affiliation:  _______________ Date:  ______________

Seasonal Address? Please give membership this information so your information will not be interrupted.

Address:  _________________________________________

City/state/zip: _____________________________________

E-mail:  ______________________ Phone:  _____________

Which months you will be at this address:

Please notify Membership of changes using this form so your information will not be interrupted.

Revised October 24, 2010