| Oklahoma Rose Society |
| Application for Membership / Renewal - 2010 |
Name___________________________________________________________
Additional Family Member's Name(s)___________________________________
Address_________________________________________________________
City_________________________State_____________Zipcode____________
Phone___________________________
E-mail___________________________
Are you a member of the American Rose Society? Yes_____No_____
Dues: ________ Individual Membership - $12.00 per calendar year.
________ Family Membership - $15.00 per calendar year.
New members joining after October 1st with full dues payment receive
credit for the following year.
Make check payable to Oklahoma Rose Society.
Mail application and payment to:
Renee Niklas
12816 Oak Hill Drive
Piedmont, Oklahoma 73078
Address_________________________________________________________
City_________________________State_____________Zipcode____________
Phone___________________________
E-mail___________________________
Are you a member of the American Rose Society? Yes_____No_____
Dues: ________ Individual Membership - $12.00 per calendar year.
________ Family Membership - $15.00 per calendar year.
New members joining after October 1st with full dues payment receive
credit for the following year.
Make check payable to Oklahoma Rose Society.
Mail application and payment to:
Renee Niklas
12816 Oak Hill Drive
Piedmont, Oklahoma 73078
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