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Sogetsu Colorado Branch - 2023 Membership Form
To join or renew your membership in Sogetsu Colorado Branch, please complete and submit the form by January 14, 2023. The membership is valid for a year (Jan.1, 2023 ~ Dec.31, 2023)
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* Indicates required question
Email
*
Your email
1. Your Name (Last, First)
*
Your answer
(Optional) Name of your spouse
Your answer
(Optional) Emergency Contact Name & Phone number
Your answer
2. Are you a new or existing member?
*
I am a new member. ---> Please fill out ALL the questions below.
I am an existing member. My information is the SAME as last year. ---> Skip to Q.10
I am an existing member. My information CHANGED from last year. ---> Please fill in the information that were changed.
3. Mailing Address
Your answer
4. Home Phone Number
Your answer
5. Cell Phone Number
Your answer
6. What is your grade in Sogetsu?
Book 1
Book 2
Book 3
Book 4
Book 5
Teacher Diploma 4th Grade
Teacher Diploma 3rd Grade
Teacher Diploma 2nd Grade (Sanyo)
Teacher Diploma 2nd Grade (Jonin Sanyo)
Teacher Diploma 1st Grade (Komon)
Teacher Diploma 1st Grade (Riji)
Clear selection
7-1. Are you a current Sogetsu Teachers Association member?
Yes
No
Clear selection
7-2. If yes, which due did you pay for 2022?
Teaching
Non-teaching
Clear selection
8. What is your flower name?
Your answer
9. Who is your teacher?
Your answer
10. Please choose your membership fee.
*
Regular : $30 ($15 after July 1, 2023)
Couples : $20 ($10 each after July 1, 2023)
Student : Free
Lifetime/Honoree : Free
(Optional) Donation for Sogetsu Colorado event fund
$10
$25
$50
Other (Please fill in the amount in the next section.)
Clear selection
If you chose "Other" above, please fill in the donation amount.
Your answer
11. Payment method options
*
Mail a Personal Check --> Payable to Sogetsu Colorado. Mail to: PO Box 270321 Superior, CO 80027
Zelle (No transaction fee) --> Please make a payment to
Sogetsu.Colorado@gmail.com
Paypal ($0.96 fee on Sogetsu) --> Please make a payment to
Sogetsu.Colorado@gmail.com
No Payment necessary
Any comments/questions?
Your answer
A copy of your responses will be emailed to the address you provided.
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