Membership Form

Beautification Council of Southeastern Michigan
MEMBERSHIP APPLICATION & RENEWAL FORM - 2024
INSTRUCTIONS:

STEP 1 - Please complete this Application & Renewal Form in its entirety

STEP 2 - Make check payable to Beautifiation Council of Southeastern Michigan

STEP 3 - Mail your dues payment to:

BCSEM Membership
Michele Hayden
20110 Maxine Street
St Clair Shores, MI 48080

*For questions or to request an IRS Form W-9, email Michele Hayden at: michayden@comcast.net
New or Renewal Membership - Choose one:*

NewRenewal
Payment Method

CheckCredit Card
Type of Membership - Choose one:*

Business, Club or Organization - $25Individual - $25Municipality - $25
Name of Municipality or Organization
Name of Beautification Commission / Committee
Name*

First NameLast Name
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Phone Number*
Please enter a valid phone number.
Email*
example@example.com

BCSEM id sn IRS-approved 501(c)(3) Tax-Exempt Organization, and a Michigan Non-Profit Corporation.
100% of your contribution is tax deductible as allowed by law.
Should be Empty:

Beautification Council of Southeastern Michigan