Participant Application Form

Landscape & Nursery Association of Greater St. Louis

Active & Allied membership (Annual dues: $75.00 + processing fee, if paying online)

Associate membership (Annual dues: $40 + processing fee, if paying online)

Student membership (Annual dues: $0 while active persuring an education in a horticulture related field)

Primary Contact Name *

First NameLast Name

Primary Email address*

Business/Organization/Individual Name*

Business/Organization Address, if applicable

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code

Type of Membership you are applying for:

ActiveAlliedAssociateStudent

Phone Number*

Please enter a valid phone number.

Website

Social Media: Instagram

Social Media: Facebook

Additional colleagues covered by membership (list up to three). Email us if you have more emails to list or add to notes section below.

Name

First NameLast Name

Email address

Name

First NameLast Name

Email address

Name

First NameLast Name

Email address

example@example.com

Main focus of your business/organization:

Notes:

Duration of membership

From (date of membership approval) to December 31st of that calendar year. Memberships completed in November or December will renew for the following calendar year. Memberships are renewed annually. Membership dues are nonrefundable

Payment by credit card

My Products

Student MembershipIndividuals currently enrolled as a student with the intention of pursuing a career in a horticulture or green industry related field. Proof of enrollment may be required.

$ Free Quantity

Active MembershipFirms or individuals actively engaged in the sale, design and/or management of ornamental plants such as, but not limited to, wholesale nursery and greenhouse growers, retail garden centers, landscape services, landscape designers and landscape architects. $75 Membership + $3.00 Processing fee

$78.00 Quantity

Allied MembershipFirms or individuals actively engaged in the manufacturing, sale, marketing and distribution of products and services allied to the horticultural industry. $75 Membership + $3.00 Processing fee

$78.00 Quantity

Associate MembershipInterested individuals not qualified for Active or Allied Member status. $40 Membership + $3.00 Processing fee

$43.00 Quantity

Total

$0.00

Credit Card Details
First Name	Last Name
Credit Card Number	Security Code
Card Expiration

Membership Application