Name:

Address:

Email:

(WAVS does not share emails)

Home Phone:

(or evening phone)

Cell Phone:

Work Phone:

(or daytime phone)

Birthday:

(month & day)

How did you hear
about WAVS?

AVSA Member?

check box if you are a member (not required)

Other plant or
gardening clubs?

Please tell us
a little about
yourself:

What types of
programs are you
interested in?

Membership fee:

$10 per year