2003 Dues
for Michigan Grape Society
$15.00 per person

Print this form and Mail to:
Van Buren MSUE, Atten: Jerri Pursley
801 Hazen St., Suite A,
Paw Paw, MI 49079

Please Print Clearly

Name________________________________________________

Address______________________________________________

City____________________________State______ Zip___________________

Phone #______________________________________________

$15 per person/1 yr. Membership (1/1/03-12/31/03) Amount Enclosed $_______

Make checks payable to: Michigan Grape Society

 

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