Name:___________________________________________ Title: __________________

Business/Agency Affiliation:________________________________________________

Address:________________________________________________________________

Phone:_______________________________FAX_______________________________

e-mail:__________________________________________________________________

NC-EPPC Membership: Student $10, General $20 per year

Please make checks payable to: NC-EPPC

Mail checks to NC Exotic Pest Plant Council c/o North Carolina Botanical Garden CB 3375 Chapel Hill, NC 27599