Native Orchid Conservation Inc.
Individual Membership Form  2003

Yes! I wish to begin or continue my membership in NOCI;  enclosed is my membership fee of   $10.00

Yes! I wish to donate to help save endangered plants and habitat;  enclosed is my donation of

[ ] $10.00[ ] $25.00[ ] $50.00[ ] $100.00[ ] $500.00 or   ______________

Name:
________________________________________________________________
Address:
________________________________________________________________
________________________________________________________________
Phone#:
________________________________________________________________
E-mail:
________________________________________________________________
Signature:
________________________________________________________________


A receipt will be issued in February.  Our Canadian Tax# is  86816 7198 RR0001.

Make your cheque out to  Native Orchid Conservation Inc  and mail it along with this form to:
Peggy BainardAcheson, NOCI Membership Chair
45 Skowron Cr.
Winnipeg MB R3W1N6