Membership Application Information

Chico Bonsai Society

  Name:

  2nd Member of Household:

  Mailing Address:

  City, State, Zip Code:

  Eve Phone:   Day Phone:

  Email:

  Annual Membership Type: Annual Membership Type: New    Renewal

  Check or Money Order:   Student $10.00      Regular $20.00     2 in same household $25.00

  I (we) have received a copy of the By-Laws of Chico Bonsai Society and understand the function of the organization and agree to uphold the by-laws.
I (we) the undersigned, hereby apply for membership in Chico Bonsai Society. I (we) release Chico Bonsai Socity from any responsibility of any injury obtained during any club activity, including but not limited to: club meetings, outings or any other activity in which I (we) am/are a part. I (we) also release the property owners, or the representative, from any and all liability that may result from any injury at any Chico Bonsai Society sponsored function.
Signed:                                                                                Date:
Signed:                                                                                Date:
amount paid:                        date:                        check#                        cash

Membership chairman initials:
This form accompanied by dues can be mailed to:
Chico Bonsai Society
PO Box 1869
Chico, CA 95927-1869
or returned at a club meeting

Name:
2nd Member of Household:
Mailing Address:
City, State, Zip Code:
Eve Phone:	Day Phone:
Email:
Annual Membership Type: Annual Membership Type: New Renewal
Check or Money Order: Student $10.00 Regular $20.00 2 in same household $25.00