Member Application Membership Form New Member Renewing Member Membership Type Individual $35 Joint $55 Under 18 Free Supporter $60 Patron $110 Benefactor $250 Name #1 First Name Name #1 Last Name Last Name Name #1 Email Email Address Name #1 Phone Name #2 (if joint member) First Name Name #2 Last Name Last Name Name #2 Email Email Address Name #2 Phone Address Address Address Address City City State/Province Alabama Alaska Arkansas Arizona California Colorado Connecticut Delaware District of Columbia Florida Georgia Hawaii Idaho Illinois Indiana Iowa Kansas Kentucky Louisiana Maine Maryland Massachusetts Michigan Minnesota Mississippi Missouri Montana Nebraska Nevada New Hampshire New Jersey New Mexico New York North Carolina North Dakota Ohio Oklahoma Oregon Pennsylvania Rhode Island South Carolina South Dakota Tennessee Texas Utah Vermont Virginia Washington West Virginia Wisconsin Wyoming State/Province Zip/Postal Zip/Postal Are you a Full-Time Resident Part-Time Resident Months Here? (if part-time) Which best describes your orchid experience? Beginner Mid_level Knowledge Advanced Knowledge Years of orchid experience? How many orchids do you own? Are you a member of the American Orchid Society? Yes No Are you a member of other plant-related organizations? Yes No ListOrganizations How did you hear about GCOA? Do you have a special skill that you can share? Are you a photographer? web-technician? accountant? carpenter? other? Occupation (or former occupation if retired)? What type of GCOA volunteer work is best for you? Committee During Monthly Membership Events Special Events Fund Raising Teaching New Member Mentorship Hospitality Plant Judging Publicity Call me when you need me OtherOther Please check all that interest you. By entering your name below you agree to abide by the bylaws of the Gulf Coast Orchid Alliance, Inc. and give permission for photographs of yourself and/or your plants to be used by GCOA for GCOA-related purposes. Type Full Name * Date * I will pay by: * Credit Card Check Credit Card * Send check to: Gulf Coast Orchid Alliance, Inc PO Box 110263 Naples, FL 34108 If you are human, leave this field blank.