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Anderson County Beekeepers Association Membership Application Form Membership year runs from January 1 st through December 31 st. Dues are: Individual - $8.00 Family - $10.00 (make checks payable to ACBA). Name: __________________________________________________________________
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Membership Application Form
Membership year runs from January 1st through December 31st.
Dues are: Individual - $8.00 Family - $10.00 (make checks payable to ACBA)
Work Phone Number: __________________
City : _______________________________ State: _________ Zip: ________________
County of Residence: ____________________________ Number of Colonies: ________
Years as Beekeeper: _____________ e-mail address: ____________________________
Membership Type: (Please check one) Individual ________ Family _________
Would you like to receive your newsletter via e-mail? Yes _________ No ____________
Our organization’s purpose is for the education, support and encouragement of beekeeping. In the interest of communication among members, do you have any objection to the above information being published in the ACBA directory? Yes __________ No __________
If so what information do you want omitted? ______________________________________
If you want to join/rejoin TBA at this time, please fill out the form below with information not shown on your ACBA form.
2009 Tennessee Beekeepers Association Membership Application 2009
Please check one: __________ New Member __________ Renewal
City : ____________________________ State ___________ Zip _____________________
County: _________________________________ Phone Number: ____________________
Local Association: __________________________________________________________
Local Association Position: (Pres. V.P., etc) ______________________________________
Check one if applicable: _____ TBA Director _____ TBA Alternate Director
TN Apiaries Registration Number (if known): ______________________________________
Number of Colonies: _____Years as a beekeeper: _____ Year joined state association: ________
Want your newsletter via e-mail? E-mail address: ______________________________________
Please select type of membership desired:
1 Year Membership Single: $10.00 _____ Family (Up to 4 family members*): $22.00 ______
2 Year Membership Single: $18.00 _____ Family (Up to 4 family members*): $40.00 ______
3 Year Membership Single $26.00 _____ Family (Up to 4 family members*): $80.00 ______
Gold Membership (lifetime): $175.00 _____
*enter names of additional family members __________________________________________
Please mail form and dues to: Petra Mitchell, Treasurer 3900 Rock Springs Rd. Watertown, TN 37184