Kentucky EPPC Membership Application
| Name ________________________________________________ |
| Address
_______________________________________________
Street, Apt. # / PO Box |
| City _______________________State _______ Zip ____________ |
| Business Affiliation _____________________ Phone____________________ |
| FAX
__________________E-Mail _______________________ |
Please check the appropriate membership category:
|
INDIVIDUAL |
INSTITUTIONAL |
| __Student $10 | __General $100 |
| __General $20 | __Contributing $500 |
| __Contributing $50 | __ Donor $501 - $10,000 |
| __ Donor $51 - $500 | __Patron $10,000 or more |
Mail completed form and check (made payable to KY-EPPC) to:
Kentucky Exotic Pest Plant Council
c/o Carey Ruff
5540 Athens-Walnut Hill Pike
Lexington, KY 40515
