Anderson County Beekeepers Association

1
Anderson County Beekeepers Association Membership
Application Form Membership year runs from
January 1st through December 31st.
Dues are Individual - 8.00 Family -
10.00 (make checks payable to ACBA)
Name ____________________________________________
______________________ Work Phone Number
__________________ Address ______________________
__________________________________________ City
_______________________________ State _________
Zip ________________ County of Residence
____________________________ Number of Colonies
________ Years as Beekeeper _____________ e-mail
address ____________________________ Membership
Type (Please check one) Individual
________ Family _________ Would you like to
receive your newsletter via e-mail? Yes
_________ No ____________ Our organizations
purpose is for the education, support and
encouragement of beekeeping. In the interest of
communication among members, do you have any
objection to the above information being
published in the ACBA directory? Yes __________
No __________ If so what information do you want
omitted? ______________________________________
If you want to join/rejoin TBA at this time,
please fill out the form below with information
not shown on your ACBA form.
2009 Tennessee Beekeepers Association
Membership Application 2009 Please check
one __________ New Member __________
Renewal Name ____________________________________
_______________________________ Street
__________________________________________________
_________________ City _________________________
___ State ___________ Zip _____________________ Co
unty _________________________________ Phone
Number ____________________ Local Association
__________________________________________________
________ Local Association Position (Pres. V.P.,
etc) ______________________________________ Check
one if applicable _____ TBA Director _____ TBA
Alternate Director TN Apiaries Registration
Number (if known) _______________________________
_______ Number of Colonies _____Years as a
beekeeper _____ Year joined state association
________ Want your newsletter via e-mail? E-mail
address ______________________________________ Pl
ease select type of membership desired 1 Year
Membership Single 10.00 _____ Family (Up
to 4 family members) 22.00 ______ 2 Year
Membership Single 18.00 _____ Family (Up
to 4 family members) 40.00 ______ 3 Year
Membership Single 26.00 _____ Family (Up
to 4 family members) 80.00 ______ Gold
Membership (lifetime) 175.00 _____ enter
names of additional family members
__________________________________________
Please mail form and dues to Petra Mitchell,
Treasurer 3900 Rock Springs Rd. Watertown, TN
37184