zTest Young Gorke Willard Knauer Lord Busk Ivancevic Fiedler Niles Melvin Miller Nessling Ware Malloy Hecker Wigginton Schreiber Vernia Donnelly Stielow Gascoigne Bitzer Synnott Estabrook Minamyer Hoeppner Sammis Reynen Latos Quinn Lutz Snyder Carr Shields Marcus Yoder Brock Spann Miller Burberry Dimeo Hildebrandt Kellogg Haley Kinkead Robert Shear Ross Bodine Imes Bibee Higdon Perkins Werges Scoville Heerwagen Stone Grootemaat McCown LaCanfora Kingham Galliker Isermann Clatt Crawford McNamara Braida Taylor Frey O"Hara Sutton Siegert Durrant Johnson Brown Cain Corkran Eicken Hansard Harriss Jensen Kenyon Lawson McKee Pejko Reale Ross Shelley Staffeldt Stagg Sudler Teetor Turner Vernon Wilhelm Harrington-Snoke Campbell Tschantz Merrick Nagan Cooley Sill Gross Raymond Moore Packard Boehmer Mack Darnell Seass Heiderman Malloy Franklin Metcalf Meister Davis Murphy McDonnell Jones Earle Wisner Maio Kappus Pulick Beadle Diamond Amundson Forbes Bentz Chambers Anderson Mainwaring Gallant Allread Selfon McAloose Friedlander Kennedy West Clark-Motley Branda Pedersoli Heacock Hyde Crescenzi Brown Curran Grassi Galton Leytze Rosenthal Curzi Chehayl Fisher Allen Sprigman Morton Borel Shea Bork Jalbert Ryan Medford Maier Hawryluk Anderson Juster Gibbs Marcantonio Kroeschell Brzoska Harris Fosberg Armbruster Colvario Tosca Miller LaRuffa Amadori Lemmon Ringler Jensen Mason Morrison Johnson Chamberlain Wilferth Frodsham Mohr test Buck Fletcher Donald Gregory Borchers Peterson Barsky Maguire Thomas Van Arsdale Arthur Stephens Hester McCauley Hennessey Roth Schweitzer Hall Underwood Giegerich Myers Thomson Farlander Duke Camalier Bawden Barry Winges MacMahon Graham Brown Fischer Reo Murphy Nevin Klingbiel Mann Pedini Schefer Westwood Shehadeh Meyer Ross Lindberg Millar Lasch Beaubien Beckhorn Green Dahl Frisicaro Coniglio Donnelly Black Payne Patrignani Cross Langslet Tweedie Greenwood Reckman Lewis Miner Corbly Marsocci Brown Conant McMenamy Johns Kappus Burr Ware Corbett McCann Weiskittel Russell Breitenbach Child Cieri Boltz Womack Maher Crossley Craig Lakefield Gifford Stevens Metcalf Aymar Bacon Learn Benson Ricci Bowen Schroeder Sampson White Knox Cullman Bradley Cluff Thomas Howat Merick Boylan Lynch Westerfield Hiltonen Kinsley Gmail Bradshaw Davis Fisk Sladick Creeth Aufranc Lewis Wilson Harvey Ehrig Vesole Whittemore Duncan Dunn McClayton Hirsch Bloecker Wardle Psaras Hatlelid Henderson Foster Basil-Fox Arends Walters Vahey Hughes Martin Hume Willson O'Neill Boyce Stadler Hansen Podolak Schmidek Foundyller Blair Schwab Abrams Hawke Pietsch Gordon O'Connell Hutchinson Marcotte McKee Marucco Sinclair Woods Grever Bigham Lockwood Bergauer Barr D'Alexander Wiehl Howe Trotto Watkins Helwig McDonald Longe Santry Corkran Fuller Wiseman Petchel Hower Ewy Arkins Lonsdale Phillips Pappas Volatile Kellam Neighbours Boyle Artandi Pfannenstiehl Duffy Lovering Clark Halloran Butler Cornell Pindyck Ciardiello Gambino Magel Means Martin Snyder Raymond Cohn Dargusch Evans LaJevic-Augustine Manley Watson Hunter Doran Eakin Stricklen Banks Murray Blackmore Deuster Laswell Dwyer Campbell Brewer Hardy Staudinger Wernig Schoenfelder Pace Milligan Haffa Hirschfield Dowiatt Treuhaft Hovland Paton Sullivan Studley Tolmie Reno Swett Foster Hickey Wenham Hale Stewart Ford Cultra Freeman Purtill Spina Schlater Merrick Falkenberg Bick carter Blackburn Alfieri Perkins Lawrence Purvis Handler Magdziarz Hughes Desrosier Schroeder Clair McGinty Leffingwell-King Raab Hill Componovo King Parobek Whitehouse Meyer Bassett Lowery Hohler Criscione Harvey McDevitt Hansell Neshek Thomas Kulpa Collins Szemis Pica DeCoursey Quaintance Stromquist Eason Burbidge Cooke Pearlstein Hadley Minnock Vender Stewart Demes Kelly Kiely Mandry Hummel Sorensen Swenson Erb Sax Okazaki Longden Fabbioli DiMare Giovannoli Name * First Last * Last NGC Badge Name Name as it should appear on badge Email * The address to which correspondence should be sent. This will be your login username. Desired Password * Enter Password Confirm Desired Password * Confirm Password I have attended a NGC General Membership Meeting prior to completing this application. Yes No General Membership meeting date: Show in Online Directory? Yes Leave blank to not show member in online directory Local Contact Information Street Address * City * State AL AK AS AZ CA CO CT DE FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY Zip Code * Enter Zip+4 if known (i.e. 34104-3735) Phone xxx-xxx-xxxx Cell xxx-xxx-xxxx Business Address? Yes Business Name Business Street Address Business City Business State AL AK AS AZ CA CO CT DE FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY Option 52 Option 53 Business Zip Enter Zip+4 if known (i.e. 34104-3735) Business Phone xxx-xxx-xxxx Business Cell xxx-xxx-xxxx Alternate Contact Information Alternate Residence Dates (i.e. June-Sept) Alternate Street Address Alternate City Alternate State AL AK AR AS AZ CA CO CT DE FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY Alternate Zip Enter Zip+4 if known (i.e. 34104-3735) Alternate Country Afghanistan Albania Algeria American Samoa Andorra Angola Anguilla Antarctica Antigua and Barbuda Argentina Armenia Aruba Australia Austria Azerbaijan Bahamas Bahrain Bangladesh Barbados Belarus Belgium Belize Benin Bermuda Bhutan Bolivia Bosnia and Herzegovina Botswana Brazil Brunei Bulgaria Burkina Faso Burundi Cambodia Cameroon Canada Cape Verde Cayman Islands Central African Republic Chad Chile China Colombia Comoros Congo Costa Rica Côte d‘Ivoire Croatia Cuba Cyprus Czech Republic Denmark Djibouti Dominica Dominican Republic East Timor Ecuador Egypt El Salvador Equatorial Guinea Eritrea Estonia Ethiopia Fiji Finland France French Guiana French Polynesia Gabon Gambia Georgia Germany Ghana Gibraltar Greece Greenland Grenada Guam Guatemala Guinea Guinea-Bissau Guyana Haiti Honduras Hong Kong Hungary Iceland India Indonesia Iran Iraq Ireland Israel Italy Jamaica Japan Jordan Kazakhstan Kenya Kiribati North Korea South Korea Kuwait Kyrgyzstan Laos Latvia Lebanon Lesotho Liberia Libya Liechtenstein Lithuania Luxembourg Macedonia Madagascar Malawi Malaysia Maldives Mali Malta Marshall Islands Mauritania Mauritius Mexico Micronesia Moldova Monaco Mongolia Montenegro Montserrat Morocco Mozambique Myanmar Namibia Nauru Nepal Netherlands New Zealand Nicaragua Niger Nigeria Norway Northern Mariana Islands Oman Pakistan Palau Palestine Panama Papua New Guinea Paraguay Peru Philippines Poland Portugal Puerto Rico Qatar Romania Russia Rwanda Saint Kitts and Nevis Saint Lucia Saint Vincent and the Grenadines Samoa San Marino Sao Tome and Principe Saudi Arabia Senegal Serbia and Montenegro Seychelles Sierra Leone Singapore Slovakia Slovenia Solomon Islands Somalia South Africa Spain Sri Lanka Sudan Suriname Swaziland Sweden Switzerland Syria Taiwan Tajikistan Tanzania Thailand Togo Tonga Trinidad and Tobago Tunisia Turkey Turkmenistan Tuvalu Uganda Ukraine United Arab Emirates United Kingdom United States Uruguay Uzbekistan Vanuatu Vatican City Venezuela Vietnam Virgin Islands, British Virgin Islands, U.S. Yemen Zambia Zimbabwe Alternate Phone xxx-xxx-xxxx Employment Status Retired Semi-Retired Employed Self-Employed Other Nickname Spouse Sponsor Name Birthday Month & Day (i.e. Dec 12) Year Birth Year Skills and Experience (Check all that apply) Naples Garden Club maintains a database of members’ skills and experiences, based on the information you provide on this form. The database is maintained by our Membership Database Manager and is accessed by the Manager when new information needs to be added and by Board members ONLY to seek volunteers for Naples Garden Club activities. Administration and Management Board Member Committee Chair Project Manager Membership Manager Event Chair/Manager Event Planner Volunteer Manager HR Manager Non-Profit Manager Legal-Policy Communication and Marketing Public Relations Writing-Editing Public Presentations Graphic Design Photography Website Management Newsletter Editor Brochure Writing Development Fundraising Grant Writing Grants Management Endowment Sponsorships Computer None Basic Intermediate Advanced Power Point Presentations Excel Word Database Education Teaching Program Development Curriculum Development Library Management Botany Environmental Science Horticulture Finance Accounting Financial Controls Budget Development Accounting Software Event Planner Experience Detail Garden Club Experience (Check all that apply) General Floral Design Horticulture Board Committee Chair Flower Show Committee Flower Show Chair Schedule Staging Clerking Horticulture Design Judges House & Garden Tour Committee H & GT Chair Site Operations Transportation Hostesses Hospitality Auction/Raffle Development House Acquisition Committee Chair Ticketing Education Committee Education Chair Design Horticulture Environment Program Committee Program Chair Production Raffle Membership Meetings Public Speaking Committee Participation Finance Governance Membership Hospitality/Events Communications Facilities/Operations Development Information Technology Electronic Communications Secretary Chaplain Historian FFGC Awards Background Educational History Include degrees and dates, most recent first Career History Include company/organization, dates, title/responsibilities, most recent first. Local (Collier/Lee Counties) Civic and Community Organizations Please explain in more detail: dates, places & events that you participated in. Include name of organization, position and/or responsibilities,, whether current or past and whether or not you served on the board. Other Civic and Community Organizations Include name of organization, position and/or responsibilities, whether current or past and whether or not you served on the board. In joining Naples Garden Club, what do you hope to gain and what do you hope to contribute? Other Affiliations of Note Are you a member of another garden club? Yes Please name: Are you a Florida Federation of Garden Clubs (FFGC) Life Member? Yes FFGC Member # FFGC City FFGC State AL AK AR AZ CA CO CT DE FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY Are you a National Garden Clubs Life Member? Yes Life Member # City State AL AK AR AZ CA CO CT DE FL GA HI ID IL IN IA KS KY LA ME MD MA MI MN MS MO MT NE NV NH NJ NM NY NC ND OH OK OR PA RI SC SD TN TX UT VT VA WA WV WI WY Do you have a National Garden Clubs judges ranking? Yes Judges Ranking (check highest completed ranking) AMJ = National Garden Clubs Judge - Accredited Master Level ALJ = National Garden Clubs Judge - Accredited Life Level AJ = National Garden Clubs Judge - Accredited Level SJ = National Garden Clubs Judge - Student Level EJ = National Garden Clubs Judge - Emeritus Level Are you a National Garden Clubs Consultant? Yes Consultant Ranking (select all that apply) NLDC=National Landscape Design Consultant NLDMC=National Landscape Design Master Consultant NG=National Gardening Consultant NCMC=National Gardening Master Consultant NEC=National Environmental Consultant NEMC=National Environmental Master Consultant Are you a member of Garden Club of America? Yes If Yes, Where? Do you have a Garden Club of America judges ranking? Yes Select your rank per category as applicable GCA-FDJ=Garden Club of America, Floral Design Judge GCA-FDJP=Garden Club of America, Floral Design Judge Prospective GCA-FDJC=Garden Club of America, Floral Design Judge Candidate GCA-HJ=Garden Club of America, Horticulture Judge GCA-HJP=Garden Club of America, Horticulture Judge Prospective GCA-HJC=Garden Club of America, Horticulture Judge Candidate GCA-PJ=Garden Club of America, Photography Judge GCA-PJP=Garden Club of America, Photography Judge Prospective GCA-PJC=Garden Club of America, Photography Judge Candidate Are you a Florida Master Gardener? Yes Are you a Master Gardener in a state other than Florida? Yes If Yes, Where? Naples Garden Club is a member of the National Garden Club and Florida Federation of Garden Clubs and as such we are required to provide FFGC with your name and address. We pay per capita dues to the FFGC based on the number of NGC members and they send you the Florida Gardener magazine quarterly. Please acknowledge your understanding by checking the box for each of the following statements. I understand that to become an Active Member I must complete the Provisional Requirements I understand that most NGC communications are electronic and I am required to be able to use e-mail and the Internet. If selected, I understand that my participation in the Provisional Program involves a commitment of time and energy. Upon becoming an Active Member, I agree to use the acquired knowledge and relationships developed in the Provisional Program to support The Club’s mission and to meet the obligations of Active membership. I understand I will be asked to serve on a committee upon achieving Active membership status. I understand I am required to attend the MANDATORY Provisional Orientation Meeting and Luncheon on April 4, 2023, Time TBD Name Name First First Last Last If you are human, leave this field blank.
