GLHBA - Membership Application Form - Annual Membership Fee $50
Business Name: ________________________________________________________

Business Address: _______________________________________________________

City: ________________ State: ______ Zip: __________

State Sales Tax #: _________________________

Name of Applicant: ________________________________________________________

Address: ________________________________________________________________

City: ________________ State: ______ Zip: __________

Phone: _____________________ Phone2: _____________________

E-mail Address: ____________________________________________________________

Web Site Address: __________________________________________________________

Short Description of your business:______________________________________________

_________________________________________________________________________

_________________________________________________________________________

_________________________________________________________________________

Please circle as many of the following service(s) that describe your business:

Aromatherapy -- Craft Shows -- Display Garden -- Garden Design -- Farmer's Market -- Dried Flowers

Dried Herbs -- Herbal Foods -- Fresh Cut Herbs Sponsor of Festival/Fair -- Lectures/Classes

Mail Order -- Health Products -- Herb Plants -- Retail Sales -- Soaps -- Teas/Luncheons -- Wholesale

**Make check payable to Great Lakes Herb Business Association. New members add $45 one time website fee.**

Send to:
GLHBA
Cassey Mieslik
4073 North Lake Road
Coulmbiaville, MI 48421