Illinois Prairie Hosta Society
Membership Form

Simply printout and return this form.

Please enroll me as a Member in the IPHS. I'm enclosing my check in the amount of $10.00 for single membership, $15.00 for family membership, or $25.00 for commercial membership.

Membership runs from January 1 to December 31 each year.

Name: ____________________________________________________________

Address: ____________________________________________________________

City, State, Zip Code: ____________________________________________________

Home Phone: _________________________________________________________

Email Address: ________________________________________________________

Please make your check payable to:
Illinois Prairie Hosta Society

Please mail this form and check to:

IPHS

Susan Krumm

508 S. James St.

Champaign, IL 61821

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