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Tulsa Rose Society

Membership Form
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2016 Membership Form

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 _________  Zip __________________

 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.)   

Are 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:

            Newsletter only (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:  
Judith 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.

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Tulsa Rose Society Gordon Beck, President  email: president@tulsarosesociety.org
Website: webmaster@tulsarosesociety.org