TRI-STATE ROSE SOCIETY OF CHATTANOOGA
Membership Application

Please print out and return the completed form with applicable dues to:
Dan Brickman
5752 Sarah Drive
Ooltewah, TN 37363
dan.brickman@att.net

Member:               _____________________________________________

Spouse Member    _____________________________________________

Dues:    Member:  $8.00        Spouse Member  $4.00    Total Dues:______

Address:                _____________________________________________

City/State/Zip:       ______________________________________________

Telephone Number (including area code):    ______________________

E-Mail Address:    ______________________________________________

Are you a member of the American Rose Society?  Yes____No____

OPTIONAL INFORMATION:
How did you learn about the Tri-State Rose Society of Chattanooga?

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How many roses are you currently growing?_______________________

What are your main rose growing interests?_______________________

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