WILMINGTON CAPE FEAR ROSE SOCIETY

2005 MEMBERSHIP APPLICATION

Mr.  Mrs.  Ms.  Name _________________________________ Spouse ________________

Address _____________________________________________ City ______________________

State __________________  ZIP _ _ _ _ _ - _ _ _ _  Phone (_ _ _) __________________

E-mail Address ______________________________________________

 NEW      Wilmington Cape Fear Rose Society Membership (Single or Family) - - - - - - - - - $15.00 per year_________

  RENEWAL  Wilmington Cape Fear Rose Society Membership (Single or Family) - - - - - - - - - $15.00 per year_________

Optional:

Combo membership includes ARS Membership and WCFRS Membership--------------$52.00 per year_________

American Rose Society Membership - - - - - - - - - - - - - - - - - - - - - - $37.00 per year __________

            If age 65 or older - - - - - - - - - - - - - - - - - - - - - - $34.00 per year _________

Carolina District Bulletin Subscription - - - - - - - - - - - - - - - - - - - - $10.00 per year _________

                                             Total _________

Make check payable to WCFRS and mail to:

WCFRS

c/o Carlos Nazario

663 Sawgrass Road

Hampstead, NC 28443

E-mail: fortex-can@msn.com