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Whether paying by online Paypal OR snail mail, please download and fill in your membership information on a copy of the Membership Application and send it by snail mail or email attachment to the HSA secretary.

If you have trouble downloading the PDF membership application, you may print out this page and fill in your membership information to apply for membership.

Dues are due on or before December 31 for the coming year. Delivery of the first issue of Frogpond for the next year will be delayed for members paying dues after December 31.

Please note that membership is for a calendar year, from January 1 to December 31. Members are strongly encouraged to join and renew during the fall months for the upcoming year. Members joining during the course of the year will receive all previous mailings for that year.



Membership Form

Our Membership / Subscription year begins January 1. All memberships are for a calendar year from January 1 to December 31. We strongly encourage members to renew during the Fall months for the upcoming year. Please send your dues to

HSA Secretary
Dianne Garcia
3213 West Wheeler Street No. 4
Seattle, Washington 98199

Membership Year
_____ 2018

Membership Status
_____ New
_____ Renewing

Regular Membership
_____ $35 United States
_____ $37 Canada and Mexico
_____ $47 Other countries
_____ $35 PDF publications Outside North America
_____ $30 senior (65 and over) in the USA
_____ $30 full-time student in the USA

Special Membership

_____ Over $35 Friend
_____ $50+ Donor
_____ $100+ Sponsor

We are especially grateful to those who choose membership in special categories; It is difficult to meet our publication and mailing expenses on income from standard memberships only.

Donation to Special HSA Initiatives

HSA Education Fund (indicate amount donated): $_______________
HSA Scholarship Fund (indicate amount donated): $_______________

Payment method

_____ Check
_____ Money Order
_____ Cash
_____ PayPal


Please make checks payable to Haiku Society of America.

Checks in U.S. funds drawn on a U.S. bank, or a bank with an affiliate in the United States, are acceptable. Otherwise, please send bank draft in U.S. funds.



State                             ZIP



_____ I would like my mailing address included in the HSA Newsletter and annual Directory.

_____ I would like my E-mail address included in the HSA Newsletter and annual Directory.

_____ I don’t want my mailing or E-mail address included in the HSA Newsletter and annual Directory.

If left unchecked, your mailing and E-mail addresses will be included in the HSA Newsletter and annual Directory.

_____ Yes, I’d be willing to volunteer for the HSA. We rely on volunteers for numerous jobs. If you have expertise in publicity, education, teaching, publications, database management, website design, or in any other field that might benefit the organization, please indicate your areas of expertise below.

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