The Potting Shed's
Preferred Customer Club
Registration Form
 
Your Name_______________________________________________________________
Street Address____________________________________________________________
POB Box#__________________________    Apt/Bldg#____________________________
City________________________________  State_______      Zip Code_______________
Daytme Telephone #_______________________________
Fax #___________________________________________
E-mail Address ___________________________________
 
One Yr. Membership @ $35.00             Five Year Membership @ 150.00
 
Paymnet method:
Check               VISA               Mastercard              Discover Card               American Express Card
 
Credit card #____________________________      Expires____/____     V Code_________
To Register as a member of The Potting Shed's Preferred Customer Club, please print this page, complete it, scan and e-mailit to The Potting Shed (theoldgrayhare@harelooms.com), fax it to (508) 861-0266 or mail the completed form to:
 The Potting Shed at PO Box # 3557 Saxonville, MA 01705.
If more convenient for you, call us (978-369-1382) and we will complete your registration over the telephone.
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