Print, complete and mail.
Name: ___________________________________
Address: ________________________________
__________________________ Zip: _________
Telephone: ( )_______________
E-Mail Address: __________________________
Number of hives maintained: _________
MI County where hives are placed: _____________
SEMBA (Individual): $10.00_____
or
SEMBA (Family): $15.00_____
Date: ____________
MAKE CHECKS PAYABLE TO SEMBA
and mail to:
Mary Sutherland
5488 Warren Road
Ann Arbor, MI 48105-9425