The Plumeria Society of America, Inc.
P.O. Box 22791
Houston, TX 77227-2791

PSA Membership Form

1. What kind of comment would you like to send?

Yes, I am interested in joining the Plumeria Society of America, Inc
Please renew my membership in the PSA

        Enter your comments in the space provided below:

2. Contact Information:

Name: R
Address: R
City: R
State: R
Zip Code: R
Country: R
E-mail: R
Tel:
Web Site:

3. Type of membership,

Regular Membership, dues are 25 US
4. Regarding publishing your name in the PSA annual Membership list and in the member only section of theplumeriasociety.org web site, please select below: (NOTE: If neither box is marked your answer will be recorded as YES)
  Publish: Name: Yes No
  Publish Address: Yes No
  Publish Telephone: Yes No
  Publish Email Address   Yes No

5. And check on of these: (if neither box is marked your answer will be recorded as YES)

Yes, add my email address to The Plumeria Society email list at YahooGroups.com
No, do not add my email address to The Plumeria Society email list at YahooGroups.com

Please contact me regarding this matter.

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