MOS ● Membership

Name______________________________ new ______ renew ______

Address ____________________________________________________

Phone (H) ________________________________ (W) _____________

E-mail ______________________________________________________

Business, optional for roster ____________________________________

Dues are $25 for one or more individuals living at the same address.

Please make checks payable to the Marin Orchid Society.

Amount enclosed_______________

Mail to: Bill Lenarz, PO Box 251, Kentfield, CA 94914-0251 - or bring this form to a meeting.