Name:___________________________________________________

Address:_________________________________________________

City/State/Zip Code:________________________________________

Home Tel No:_____________________________________________

Work Tel No:_____________________________________________

Email address:_____________________________________________

Our newsletter is published once a month. Everyone with an email address will receive an email when it is available on the web. This is a full color version. You can also receive it via US Mail, but this will not be in color. If you do not have an email address, you will receive it via US Mail.

_______Please indicate if you wish to also receive a mailed version with a Yes.

Are you a member of the American Rose Society (ARS)?____________

Optional: Current number of Rose Bushes:______ Number of Years Growing Roses:_____

Please send your completed form with your check made out to "GGRS" for your annual dues to our Treasurer (address below). Use the table below to determine what you owe.