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.