MEMBERSHIP APPLICATION
	(membership year: Jan. 1 - Dec. 31)
	I/We wish to join the Carolina Butterfly Society.
	A check is enclosed for:
	___ Individual Membership ($15)
	___ Family Membership ($15)
	___ Corporate/ Institutional Membership ($25)
	PLEASE PRINT CLEARLY
	Name(s): 1) ________________________________________
	2) _______________________________________________
	Address:
	Street _____________________________________
	City ____________________ County ____________
	State _____ Zip ______
	Telephone (___)___________ Fax (___)__________
	E-mail Address: ______________________________
	Butterfly-related Interests
	(applicant #1 use first space, applicant #2 use second space.)
	__ __ Watching butterflies	__ __ Butterfly counts
	__ __ Keeping a life list	__ __ Raising butterflies
	__ __ Butterfly Gardening	__ __ Butterfly research
	__ __ Field trips	__ __ Education
	_ __ Photography	__ __ Conservation
	Other related interests: 1) _______________________________
	Do you already belong to NABA?
	1) __ yes __ no	2) __ yes __ no
	PLEASE PRINT OUT AND MAIL THIS MEMBERSHIP
	APPLICATION ALONG WITH YOUR DUES CHECK TO:
	CAROLINA BUTTERFLY SOCIETY
	PO Box 18771
	Greensboro, NC 27419