Sidewalk Astronomers Membership Form
 
NAME ______________________________________________
ADDRESS ___________________________________________
CITY/STATE/ZIP
         _____________________________________
TELEPHONE _________________________________________
EMAIL _______________________________________________
    New
         Membership or new contact information ____    
 Renewal with no changes ________
 I am enclosing
         a check for $15 for dues _____ 
 I am not enclosing a check
         but would like to remain on the mailing list _____
 I have
         paid my dues within the last 90 days ______
 I no longer wish
         to receive information _____  
 I am enclosing
         $25 for dues because I prefer to receive information by post _______   
I am making a contribution but don’t wish to receive information _______
Please return completed form to address at top of page.