MEMBERSHIP FORM





























FOR INTERNAL USE ONLY
Date Paid:                                                                      
 Cash       Check #               Renewal       New Member
Your Name
 
 Business Name or
 Employer Name
 
Home Address
Street:
City:
Zip code:
Contact Information
E-mail:
Home Phone:
Work Phone:
Cell Phone:
Fax:
Preferred Method of
Communication
 E-Mail                Home Phone      Cell Phone
 Work Phone      Mail
Website
 
Education
 
Number of years in the
Green Industry
 
Services/Specialties
(check all that apply)
 Landscape Design            Installation
 Maintenance                    Horticulurist
 Nursery Owner/worker   Certified Arborist
 Sales                                Speaker
 Other (Describe):
Maximum 50 word
description of your
services
 
New Members
Please complete all of this form and return with payment
as instructed below.  Upon acceptance, you will be added
to our online roster.
Member Renewal
Please make any necessary corrections to your roster
listing and return with payment as instructed below.  
Renewal deadline is the second Friday of September.
Payment Information
Renewal and new membership dues are $25.00.  Please
make check payable to The Design Network.  Mail to
Patricia Basar, 7991 Sunstone Drive, Brecksville, Ohio
44141
Women Committed to the Green Industry of Northeast Ohio
www.thedesignnetwork.org