John Bartram Association Membership Application

Please print application, complete and mail with payment (checks payable to John Bartram Association) to:

Bartram’s Garden
54^th St. & Lindbergh Blvd. , Philadelphia, PA 19143

Yes, I would like to join the John Bartram Association,
Please sign me up as a:

____ $ 1000 Collector
____ $ 500 Explorer
____ $ 250 Botanist

____ $ 100 Naturalist
____ $ 50 Household
____ $ 35 Individual

Member name as you
wish it to appear in our records:

_____________________________________

Street Address:

_____________________________________

_____________________________________

City, State, Zip:

_________________________ ___ , _______

Phone: (______) ______ - _________

Email address:

_______________@____________________

This is a gift membership from:

_____________________________________

Street Address:

_____________________________________

_____________________________________

City, State, Zip:

_________________________ ___ , _______

Phone: (______) ______ - _________

Email address:

_______________@____________________

Type of payment:   Check___   Visa___   Mastercard___

Card Number: __________ __________ __________ __________

Exp. Date: (mo/year) _______ / _____________

Signature: _______________________________________________

Questions? Call (215) 729-5281 Thank you!

____Please waive my benefits (above the household level)
       in return for a full tax deduction

____I am a Bartram Descendant

____I am an Eastwick Descendant

____I am interested in supporting the Bartram Endowment Fund, please
       send more information.

____I have included a bequest to the John Bartram Association in my will.

A copy of the official registration and financial information of the John Bartram Association

may be obtained from the Pennsylvania Department of State by calling toll-free within Pennsylvania

1-800-732-0999.  Registration does not imply endorsement.