KNPS Membership Form

"*" indicates required fields

Name*
Address*
If you live in Kentucky could please provide us with the county in which you live.
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Is this a New Membership or a Renewal?*
For How Many Years?*
Please select how many years of membership you would like. Please note that with a 3 year membership you will receive a 10% discount on your membership.

The membership levels do not appear until you make a selection here. If you are wanting to join at the Lifetime level, just select One Year.
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I would like to help out KNPS with (check all that apply):
If you would like to make an additional donation to KNPS, please just enter the amount here. Memberships and donations are tax deductible.
Required for Institutional membership, optional for others
Additional Lady Slipper Recipients
If you have additional family or friends who would like to receive our e-newsletter, The Lady Slipper please provide their names and email addresses below. You can click on the plus sign at the end of the row to add more names.
Name
Email Address
 
Payment
American Express
Discover
MasterCard
Visa
Supported Credit Cards: American Express, Discover, MasterCard, Visa
  
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