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.