St. George Botanical Garden

Membership Form - Mail or Fax

New Membership


I would like to support the conservation and education projects of St. George Village Botanical Garden by becoming a member at the category checked below:

	Individual $50
	Senior (60+) $35
	Couplel $75
	Senior Couple $55
	Bronze Palm member $150
	Silver Palm member $250
	Gold Palm member $500
	Platinum Palm member $1000

Your name

Address

City State Zip

Phone Email (if applicable)

Gift Membership


	Individual $50
	Senior (60+) $35
	Couplel $75
	Senior Couple $55
	Bronze Palm member $150
	Silver Palm member $250
	Gold Palm member $500
	Platinum Palm member $1000

Recipient's name

Recipient's address

City State Zip

Phone Email (if applicable)

Payment Information
Visa or MasterCard # Exp. Date

Signature
Required on all credit card orders

Please print and mail or fax this form (with a check or money order if applicable) to
St. George Village Botanical Garden
127 Estate St. George
Frederiksted, VI 00840
fax: (340) 692-6154