Haymarket Town & Country Garden Club Membership Application

  • The Member Roster is printed,
    but not published online.

    The best size is 600 x 600 pixels.
    The best format is JPG.
    The best crop is a headshot
    that includes shoulders and
    has a simple background.

  •  

  • The date you first joined the club
     - -
  • Change Date
     - -
  • I am:*

  • 1. We do our best not to include last names online (website, Facebook, marketing). The exception is that the member wants or needs to use their last name.
    2. This information is printed in our Membership Roster: Photo, Name, Partner (lifespan if desired), Year joined, Address, Phone(s), Birth Month and Date (no year), and Email(s)
    3. Your image and or first name may be used on our website or for social media. No last names are used.

  •  

    Optional. If your spouse has passed, their name can be followed by their lifespan. i.e. Roger 1928-2017


  • Format: (000) 000-0000.
  • Phone 1 is*
  • Format: (000) 000-0000.
  • Phone 2 is
  • How did you learn about us?*
  • Have you been, or will you be an Executive Board Member for any of the following?
  • Check any areas that you would enjoy.
  • PAYMENT METHOD $45 annual dues*

  • PAY BY CHECK

  • Should be Empty: