2011-2012 VMSMA Membership

MEMBERSHIP APPLICATION
November 1, 2011 - October 31, 2012

Application Type:	Renewal   New
Business Name:
First Name:
Last Name:
Email:
Phone:
	Mailing Address
Address:
City:
State:
Zip:

Membership and Other Fees

$25.00 ~ 100 to 749 taps ~ voting member
$35.00 ~ 750 to 3,999 taps ~ voting member
$45.00 ~ 4,000 taps and over ~ voting member
$25.00 ~ non-voting member (A Vermont maple producer with less than 100 taps or any person, company or
organization with an interest in supporting the Vermont maple industry.)

* To be a voting member you must have set at least 100 taps and/or produced 25 gallons of maple syrup
in 2 of the last 5 years.

Maple Publications
You can now sign-up for these maple publications through VMSMA.

$18.00 ~ The Maple News ~ a privately owned publication that reports on maple news from all
around the maple industry. (8 issues a year)
$6.00 ~ The Maple Digest ~ the official publication of the NAMSC, research being done at the
Proctor Maple Research Center and other maple research centers with financial help from the North
American Maple Syrup Council will now be published in this paper. (4 issues per year)

Donation to "Operation Vermont Maple Sweetness", a project to deliver VT Maple to our troops as a thank-you for their service: $

Total Payment: $

Civil Rights and Equal Opportunity
As VMSMA receives federal grant funding we are required to provide the following information in order to monitor compliance with the civil rights law. You are not required to furnish this information, but are encouraged to do so. If you do not wish to furnish the following information, please check the box below.

Ethnicity	Race	Gender
Hispanic or Latino Not Hispanic or Latino	American Indian or Alaskan Native Asian Black or African American Native Hawaiian or Other Pacific Islander White	Male Female

I do not wish to furnish this information

VMSMA is an equal opportunity provider