MIDWEST NUT PRODUCERS COUNCIL: MEMBERSHIP FORM

Please mail this completed form with your check or money order made payable to MIDWEST NUT PRODUCERS COUNCIL to:

William Nash
Attn: MNPC
4975 Grand River Road
Owosso, MI 48867 USA

NAME ___________________________________ PHONE: home ________________

COMPANY _____________________________________ business _________________

ADDRESS ____________________________________ FAX ____________________

______________________________________________________________________

CITY, STATE/PROVINCE, COUNTRY______________________________________

ZIP/POSTAL CODE_____________________________________

EMAIL ADDRESS_______________________________________

Please indicate your category(s) for our membership directory:

____ Wholesale Grower ____Retail Grower ____ Marketing/Distribution

____ Research/Education ____ Nursery Production ____ Employee(category)

Please check the committee(s) on which you may be willing to serve:

____ Cultivar/Culture ____ Market Development ____ Membership

____ Publications ____ Quality Standards

ANNUAL DUES: ____ REGULAR: $50.00 (growers, nurserymen, businesses)

____ ASSOCIATE $10.00 (research/educators, extension workers, employees of MNPC members, students, etc.)

____RENEWAL ____ NEW MEMBERSHIP