Date

Name (s)
Address
City 
State   Zip+4
Phone (s)
Email

Check the desired membership.

Individual ($5.00)      Family ($7.50)       Business ($15.00)

Please make your check payable to:   The Wisconsin Daylily Society

Mail this form with your payment to:

Kathi Dwelle
1003 Oak Way
Madison, WI 53705

608-233-1516