KOS Membership/Application/Renewal Form

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Check One:

Individual Membership, $10 per calendar year Renewal New
Family Membership, $15 per calendar year Renewal New
Life Membership $200

First Name Last Name
Spouse/Significant Other
Address City State Zip
Phone
e-Mail Address

I prefer to receive the Kansas Orchid Society Newsletter by (select one):

e-Mail
US Mail

Print this form and attach a check payable to the: Kansas Orchid Society

Bring form and check to the next meeting, or mail to:

Kathy Ethridge , KOS Membership Chairperson
1619 S. Rutan
Wichita, KS 67218

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