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Membership Application
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**Regular Memberships**
Quantity	Membership Type	Price
	Standard (individual or joint) for 1 year	$45. each	=
	Standard (individual or joint) for 2 years	$75. each	=
	Standard (individual or joint) for 3 years	$105.each	=
	Sustaining for 1 year	$60. each	=
	Sponsoring for 1 year	$120. each	=
	Life	$600. each	=
Total Amount			=

**Commercial/Institutional Memberships**
Quantity	Membership Type	Price
	Standard for 1 year	$60. each	=
	Sustaining for 1 year	$120. each	=
Total Amount			=

Please Print
Your Name (list both names for joint membership ): ________________________________________________
Address (commercial/institutional members, list contact person):__________________________________________
_______________________________________________________________________________
City: __________________________ State: _____________ Postal Code:_____________
Country: ________________________________ E-mail:_______________________________
Home Phone: ________________ Office Phone: _______________ Fax: ________________ ( ) May ( ) May not release home phone* ( ) May ( ) May not release office phone* ( ) May ( ) May not release fax* *Only published in membership lists distributed to members

Please fill out the following for gift memberships:

Please Print
Your Name (list both names for joint membership ): ________________________________________________
Address (commercial/institutional members, list contact person):__________________________________________
_______________________________________________________________________________
City: __________________________ State: _______________ Postal Code: _____________
Country: ________________________________ E-mail:_______________________________
Home Phone: ________________ Office Phone: _______________ Fax: ________________ ( ) May ( ) May not release home phone* ( ) May ( ) May not release office phone* ( ) May ( ) May not release fax* *Only published in membership lists distributed to members

Make checks payable (in U.S. funds or international Money Order) to:
Holly Society of America, Inc.

Print page, fill out, and send along with payment to:
Holly Society of America, Inc.
P.O. Box 803
Millville, NJ 08332-0803

The Holly Society of America

Holly Society of America