Membership Application Mycological Association of Washington, Inc. Mail to: MAW Membership Chair, PO Box 76533, Washington, DC 20002

Name_______________________________________________________ Address____________________________________________________ ___________________________________________________________ Telephone: Home___________________________ Work___________________________ Fax:___________________________ E-mail____________________________________ Dues enclosed: $_____________ ($20.00 Individual, $30.00 Household) I understand that the Mycological Association of Washington, Inc. (MAW) is not responsible for any harmful effects that I can suffer as a result of the collection and consumption of fungi, even though they can occur while participating in activities sponsored and organized by MAW. Signature___________________________ Date________________ Interests: ____Mycology ____Photography ____Forays ____Mycophagy/Culinary ____Microscopy ____Taxonomy ____Books ____Toxicology ____ Other_______________________ *********************************** Annual dues for optional NAMA membership for individuals or families who are members of the Mycological Association of Washington, Inc. are $32.00. To join, enclose a separate check payable to the North American Mycological Association and complete the following form (even if you've filled out the top part), and send it to the MAW Membership Secretary at the above address: Name______________________________________________________ Address(Zip+4)____________________________________________ __________________________________________________________ Telephone: Home___________________________ Work___________________________ E-mail_____________________________________________________ Current members need only fill out this form to update the above information.