The Garden Club of Indiana, Inc.
Member of National Garden Clubs, Inc.
Associate Life Membership Form

Associate Life Member: Associate Life Member is a non-garden club member sponsored by an individual garden club member and/or a garden club affiliated with The Garden Club of Indiana, Inc. They may attend State and/or District meetings, but shall have no voice or voting privileges. They may not hold office; however, they may subscribe to The Indiana Gardens.
Please complete this form, enclose check made payable to The Garden Club of Indiana, Inc. and mail to State Scholarship Chairman Paulette Balmer, 4541 W Randy Road, Edinburgh, IN 46124-9189
 by December 1st.

Date check in the amount of $50.00 sent
Check district you are a member of  C
    NW     NC     CE        
                                                  SE  
    SW     CW          

                                                                                                                                     
Check the appropriate category:    Individual Gift          Amount:
                                                     Club                      Amount:
                                                     District                   Amount:
Name of New Member
:

Address:

City: State: Zip:

Donor's Name (if sponsored):

Address:

City: State: Zip:

If Garden Club is sponsor, indicate club: District:

Name of Person Sending Check:

Address:

City: State: Zip:

Phone Number:

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