THE BOSTON MYCOLOGICAL CLUB

APPLICATION FOR MEMBERSHIP

Fill out this form and then print it and post-mail it with your check (payable to "Boston Mycological Club"). The address to send to is at the bottom of this page.

I/We hereby apply for membership in The Boston Mycological Club.

Name (names of family if applying for Family membership)

Address (street address, city, state and zipcode, country)

Primary Telephone: (include area code)

E-mail address:

Amount of Dues enclosed (make check payable to "Boston Mycological Club")
$20.00 (Individual member)
$25.00 (Family membership)
$10.00 (Junior - age under 21 years)

Send to:

    Boston Mycological Club
    Membership Secretary
    35 Red Acre Road
    Stow, MA  01775-1108

www.bostonmycologicalclub.org