Holly Society of America, Inc.

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Membership Renewal Application
Print Page, Fill Out, And Mail

**Regular Memberships**
Quantity	Membership Type	Price
	Standard (individual or joint) for 1 year	$30.00 each	=
	Standard (individual or joint) for 2 years	$55.00 each	=
	Standard (individual or joint) for 3 years	$80.00 each	=
	Sustaining for 1 year	$60.00 each	=
	Sponsoring for 1 year	$120.00 each	=
	Life	$600.00 each	=
Total Amount			=

**Commercial/Institutional Memberships**
Quantity	Membership Type	Price
	Standard for 1 year	$60.00 each	=
	Sustaining for 1 year	$120.00 each	=
Total Amount			=

Please Print
Your Name (list both names for joint membership ): ________________________________________________
Address (commercial/institutional members, list contact person):__________________________________________
_______________________________________________________________________________
City: __________________________ State: _____________ Postal Code:_____________
Country: ________________________________ E-mail:_______________________________
Home Phone: ________________ Office Phone: _______________ Fax: ________________ ( ) May ( ) May not release home phone* ( ) May ( ) May not release office phone* ( ) May ( ) May not release fax* *Only published in membership lists distributed to members

Please fill out the following for gift memberships:

Please Print
Your Name (list both names for joint membership ): ________________________________________________
Address (commercial/institutional members, list contact person):__________________________________________
_______________________________________________________________________________
City: __________________________ State: _______________ Postal Code: _____________
Country: ________________________________ E-mail:_______________________________
Home Phone: ________________ Office Phone: _______________ Fax: ________________ ( ) May ( ) May not release home phone* ( ) May ( ) May not release office phone* ( ) May ( ) May not release fax* *Only published in membership lists distributed to members

Cannot accept credit cards at this time. Paypal coming soon.

Make checks payable (in U.S. funds or international Money Order) to:
Holly Society of America, Inc.

Print page, fill out, and send along with payment to:
Holly Society of America, Inc.
309 Buck Street
P.O. Box 803
Millville, NJ 08332-0803
USA