Tulsa Rose Society
Application for Membership/Renewal
(Everyone should complete the following information)
Last Name___________________________________ First Name_________________________________
Spouse or Household Member's Name_______________________________________________________
City_______________________________________________ State _________
Home Phone: ____________________
Bus. Phone: ________________ Cell Phone: _________________
Other Interests or Hobbies: ________________________________________________________________
Email: ________________________________________________ Renewal
( ) New Member (
Would you like to receive our newsletter electronically?
( ) No ( ) Yes
(Email address required.)
you a member of the American Rose Society? (
) No ( ) Yes
Tulsa Rose Society Membership:
Membership dues are $20.00
Would you like your Roster mailed to you? $1.50 for postage and handling
South Central District Membership:
(Quarterly) $5.00 (Electronic only) Email required
Patron Supporter includes newsletter Family $40.00
Individual $25.00 $
Donation to Tulsa Rose Society Trophy Fund
The Tulsa Rose Society is a not for profit organization (501-c-3) and
your donation may be
tax deductible. Consult your accountant or tax advisor.
Total Membership Fees & Donations
Please make check payable to: Tulsa
Rose Society and mail with this application to:
Carter, 1825 W Lincoln St, Broken Arrow, OK 74012
Tulsa Rose Society Dues are based upon the calendar year and due January 1st each year.
Members joining after June 30th only pay 50% of the regular dues amount. Members paying by
February 1, 2016 will be included in the 2016 Membership Roster.
The Treasurer will forward membership information to appropriate organizations
along with the appropriate payment.