Membership Application / Renewal Form


___ NEW MEMBER APPLICATION                                                     ___ RENEWAL

 
NAME : ___________________________________________________________
 
ADDRESS : ___________________________________________________________
 
CITY, STATE & ZIP : ___________________________________________________________
 
PHONE : ______________ EMAIL : _______________________________
 
VINEYARD NAME : ___________________________________________________________
 
VINEYARD LOCATION :   County: ______________________________   State: ___
 
COMPLETE THIS SECTION IF YOU CURRENTLY CULTIVATE GRAPEVINES

I have approx ______ vines. These include: ______ # of vine grapes; ______ # of table grapes

The grapes are grown for : __HOME USE     __PICK YOUR OWN     __READY PICKED     __COMMERCIAL

 
COMPLETE THIS SECTION IF YOU DO NOT CULTIVATE GRAPEVINES

My interest in / affiliation with grape growing is: ___GENERAL INTEREST     ___WINE DRINKER / MAKER

___FUTURE GRAPE GROWER     ___EXTENSION SERVICE     ___LIBRARY     ___UNIVERSITY

DEALER (specify) : ________________________________________________

OTHER (specify) : ________________________________________________

 
The MGGA Membership Directory is published annually in The Maryland Grapevine.
Please specify the information that you wish included in The Directory.

___INCLUDE ALL INFO     ___OMIT PHONE     ___OMIT ADDRESS     ___OMIT EMAIL ADDRESS


One Year Subsription: $50    -    Two Year Subsription: $90    -    Three Year Subsription: $120
Please make check payable to MGGA


Mail to:
THE MARYLAND GRAPE GROWERS ASSOCIATION
PO BOX 194   Hyattsville, MD 20781-2051