“MEMBER GET A MEMBER CAMPAIGN”
LOUISIANA BEEKEEPERS ASSOCIATION, INC.
Name: Parish: __________________________
Street Address: ________________________________________________________________
City: State: Zip: ____________________
Phone: _________________________ E-mail address: ________________________________
ANNUAL MEMBERSHIP DUES: o NEW MEMBER o RENEWAL
____ Hobby (1 - 24 colonies), Intermediate (25 - 249 colonies), Commercial (250 + colonies) - $10.00
____ Affiliate (club support of state association activities) - $25.00
Please send your check or money order payable to the Louisiana Beekeepers Association Inc.
c/o David Ferguson, P. O. Box 716, Brusly, LA 70719 Ph. 225/413-6627
Products Sold: ____ Equipment____ Honey____ Pollen____ Packaged Bees____ Queens ____ Wax___
Services Rendered: ____Bee Removal ____Swarm Gathering ____Pollination ____Other (list below)
Referred by: ______________________________________ Date: _________________