ANNUAL MEMBERSHIP APPLICATION

Dues for Year:__________________

Name:
Address:
City:
Phone:

State:
Home:

LA

Zip:

Cell:

Work:

Occupation (current/past):
E-mail:
E-mail notification of MG news/

Yes No
events:

Year of LMG Class:

Active

Status:

Inactive / Leave of Absence

New Graduate

Plant Society Membership(s):

Specific gardening
interests/expertise:
Are you willing to serve as an officer or board member?

Yes No

Are you willing to chair a committee?

Yes No

Are you willing to speak to groups?

Yes No

Please select committee(s) you may wish to join:

Education

Finance

Communications

Schools Gardens
Membership

Farmer's Market

Nominations

Projects / Speakers

Special Events

Please identify any special skills that may benefit MG:

Computer

Writing

Graphic Design / Art

Photography

Organizational

Fund Raising

Public Speaking

Carpentry/Construction

Other:
VOLUNTEER PHOTOGRAPH NOTIFICATION: Project Leaders are encouraged to document their efforts
with photographs of their Master Gardener volunteer activities. These photos may be published on the
various websites and newspapers which aim to inform our membership about volunteer opportunities and
happenings. Names may or may not be printed in association with these photos.
I am a Master Gardener graduate and agree to meet the annual 20 hours volunteer and 6 hours education
requirements of the LSU AgCenter Master Gardener program.
SIGNATURE:

Date:

Dues are $20.00 annually, due by January 31 of the new membership year, and are delinquent on February 1st.
Please make your check payable to TPMG and send it with this completed application to:
TPMG, P.O. Box 848, Amite, LA 70422

OFFICE USE ONLY

Date Check Received:

Check #:

Received By:

Rev: 1/2017
This form is also used to keep your contact information current.

____________________________________________________________
Last name,
First name
Date
Paid

MASTER GARDENERS of TANGIPAHOA PARISH