Membership Application
( Membership From January 1 - December 31 )

Name____________________________

Title_____________________________

Organization_______________________

Address__________________________

City/State/Zip______________________

Telephone_________________________

Fax______________________________

• Individual/Family
  (annual)......................................$15

• Group/Municipal*........................$50

• Lifetime....................................$500

• Enclosed is my gift (tax deductible) to the fu-
  ture of trees $__________.

• Total amount $ _________.

Please make your check payable to: The Kansas Urban Forestry Council

Then mail to:

Chuck Evanhoe(Treasurer)
The Kansas Urban Forestry Council
1412 Dry Stream Ct.
Derby, Kansas 67037