Membership Application � GCRS - 2005

Mr. Mrs. Ms. Dr. _________________________________________Date:______________

Please Print First and Last name

____________________________________� Phone:� Home ______ Work _____________

List Spouse and other family members

Address:� ________________________________________________________________

City, State, Zip: ____________________________________________________________

E-Mail Address:� ___________________________________________________________

Renewal___��� New Member ___���� Gift Membership ___

Member of American Rose Society?� Yes��� No ���� �How many years____ Number of roses grown:� ____

Occupation ________________________� Hobbies (other than roses) ________________________�

Do you want to receive The Rambling Rose via e-mail?� Note it often has color photos ����Yes���� No�

Dues are $15.00 per calendar year (single or family at same address). Make checks payable to Greater Columbia Rose Society� and send to

David Durham

449 Annondale Road

Columbia, SC� 29212

Please indicate in order of your preference (1,2 & 3) which committee you would most enjoy:

��������� ��������� ___Hospital Rose Garden�������� ��������� ��������� ___Garden Tour

���������

��������� ��������� ___ Membership� ������������������� ��������� ___Telephone

��������� ��������� ___Newsletter�������� ������������������� ��������� ___Refreshments

��������� ��������� ___ Rose Show�� ������������������� ��������� ___Education

Your comments and program suggestions are welcome.� Use the back of this form or enclose a note with your remarks.