FORM OF APPLICATION 
for Admission to Membership in the 
Long Island Horticultural Society, 
Incorporated 
I hereby apply for membership in the Long Island Horticultural 
Society and wish to subscribe to the class of membership as indicated 
below. [Please mark with letter x to designate your choice]. 
A—Annual Membership Dues $5.00 per year 
B—Sustaining Membership _ Dues $10.00 per year 
For 15 consecutive 
years thereafter be 
coming alifemember 
C—Life Membership _ . _ On Payment of $100 00 
D—Patrons On Payment of $250.00 or more- 
Signed _—___ __ __ 
[Please print name and state whether Mr., Mrs. or Miss] 
Address 
Date 
and I- -, being a member of 
the Long Island Horticultural Society, Incorporated, recommend the above 
named applicant for membership in the Society 
Approved by 
Date 
