Please fill out in triplicate and mail all three copies to the District Director who will forward to the First Vice-President with duplicate membership list and check for dues and initiation fees.  Youth Gardener Clubs - send to Youth Chairman

Application of Club for Membership in
THE GARDEN CLUB OF NORTH CAROLINA, INC.
                                                                                     Date of Application _____________________
Name of Club _____________________________________________________
[   ]  Adult Club     [   ]Youth Gardener Club       Ages _______________________
Name of Town  ____________________________________________________
Date of Organization __________________    Number of Paid Members  ________
By Whom Recommended? Name of Club ____________________________
President Sign ____________________________
Initiation Fee _________ Adult, $5.00 Per Club        _______   Youth, $1.00 Per Club
Annual Dues _________ Adult, $6.00 Per Member   _______  Youth, $0.25 Per Member
Reinstatement ________ $0.35 Per Member
(Including membership in National Garden Club)
(Only adult annual dues include subscription to The North Carolina Gardener)
OFFICERS OF CLUB
President  ____________________________________________________________
  Address ____________________________________________________________
Treasurer ____________________________________________________________
  Address ____________________________________________________________
Application Approved __________________________________________________
                                                        (District Director Signature)
District No. ________    County ____________________   Date  ________________