PAWTUCKAWAY
BEEKEEPER'S ASSOCIATION
APPLICATION FOR MEMBERSHIP 2008

YEARLY DUES $10.00

Please fill out this form, print it, and mail to the address below.
DATE:
NAME:
STREET:
TOWN:
STATE: ZIP:
E-MAIL:
TEL#:
# OF COLONIES:
MEMBERSHIP IS:
(select one)
 NEW       RENEWAL       GIFT

Check here if you would prefer to receive the PBA newsletter by email:

Make check payable to PBA or Pawtuckaway Beekeeper's Association and mail with completed form to: Sec. PBA, Ellie Palmer, 141 Hampstead Rd., Sandown, NH 03873

I HAVE ELECTED TO ENCLOSE AN ADDITIONAL $10 FOR MEMBERSHIP IN THE NEW HAMPSHIRE BEEKEEPERS' ASSOCIATION FOR 2006.
           [Include $10 in PBA check or send separate check.]

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