SEMBA MEMBERSHIP APPLICATION

Print, complete and mail.


   Name:  ___________________________________ 

   Address:  ________________________________ 

    __________________________  Zip:  _________ 

    Telephone:  (      )_______________ 

    E-Mail Address:  __________________________ 

    Number of hives maintained: _________  
    MI County where hives are placed: _____________

    SEMBA (Individual):  $10.00_____ 
         or
    SEMBA (Family):      $15.00_____ 

    If you pay SEMBA dues, you may join or renew
    the state organization, Michigan Beekeepers'
    Association (MBA), for the additional amount
    of $25.00 per individual or $30 per family:   _____

    Date:  ____________ Total:  ___________ 


    MAKE CHECKS PAYABLE TO SEMBA 
    and mail to:
                      Mary Sutherland 
                      5488 Warren Road 
                      Ann Arbor, MI 48105-9425