Name *

First Name

Last Name

Address *

Address 1

Address 2

City

State/Province

Zip/Postal Code

Country

Checkbox

Place an X in the box of any role you would be willing to help, if the need should arise. (Committee time counts as VMS hours)

Fundraising

Hospitality

MGWWC Board

Membership

Merchandise

Monthly Speaker Admin

Special Events

Website

Are you an active Certified Master Gardener normally recording hours in the VMS system? *

Yes

No

If applicable, may we use your name &/or photo on our website?

Name

Photo

I am paying by: *

Check ($20)