You are here

Facebook icon
LinkedIn icon
RSS icon

Membership - the Maple Society (only the North American Branch)

Application for Membership of the North American Branch.

Please fill out the following form and send the form and payment to:

Bart & Marielle Eykemans,
TMSNAB
P.O. Box 2635
Port Angeles, WA 98362
USA

Make checks or money orders payable to "The Maple Society, North American Branch (TMSNAB)" and drawn on a US bank account.

Please print.

Name:  
Company:  
Address:  
City, St/Pr:  
City, St/Pr:  
Telephone: work/home (      )
E-Mail:  
Payment type and amount: Check: VISA: Mastercard:
Card number: Expiry date:
Card Validation Code (last 3 digits on back side of credit card):
Signature: Date:
Gift Membership Given By:

Annual Subscription Rates are as follows (please circle choice):

Individual:
Family:
Associate / Library:
Corporate / Business:
Sustaining:
Life Membership (Individual):
Life Membership (Couple):
$35
$50
$50
$100 *
$125
$750
$1000
To be filled out by TMSNAB Membership Secretary:
Date Received:
Processed:
First Issue:

(* Corporate/Business membership includes opportunity for ad in each newsletter)

Twitter icon
Facebook icon
Google icon
StumbleUpon icon
Del.icio.us icon
Digg icon
LinkedIn icon
Newsvine icon
Pinterest icon
Reddit icon
Yahoo! icon
e-mail icon