Kansas Nursery and Landscape Association Membership Application
Company name
*
Address
*
City/State/Zip
*
Email
*
Website
Phone Number
*
-
Work
Mobile
Name(s) & Title(s) of Individual(s) Representing Your Company, Title
*
Name(s) of Individual(s) Renewing Nurseryman Certification***
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next
( X )
***Certified Nurseryman Renewal - #1
(
$
25.00
for each
year
)
***Certified Nurseryman Renewal - #2
(
$
25.00
for each
year
)
EXECUTIVE MEMBERSHIP
(
$
750.00
for each
year
)
VIP MEMBERSHIP
(
$
500.00
for each
year
)
ACTIVE BUSINESS MEMBERSHIP
(
$
200.00
for each
year
)
INDIVIDUAL MEMBERSHIP
(
$
70.00
for each
year
)
EDUCATOR MEMBERSHIP
(
$
30.00
for each
year
)
STUDENT MEMBERSHIP
(
$
30.00
for each
year
)
KNLA SCHOLARSHIP FUND
(
USD
for each
year
)
Total
$
0.00
Credit Card
Submit
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