GRAAA Membership Application Form

Grand Rapids Amateur Astronomical Association

Membership Application Form

DATE:____________

Please fill out the information below as completely as possible.
For Family memberships, please include all persons for whom membership is desired.

Address: _____________________________________________________________________________

City: _________________________________

State: ___________

Zip: ________________

Home Phone: ______________________________

Cell Phone: ______________________________

E-Mail: ____________________________________________________________________________

(Note: For Family members, if more than one e-mail address, please list others on back of application)

q	Adult	(18 or older, a Minimum of $40.00) . . . . . . . . . . . . . . . . . . . . . . . .	$_________
q	Student	(through 17 yrs old, a Minimum of $25.00) . . . . . . . . . . . . . . . . . .	$_________
q	Family	(all members of one family, a Minimum of $50.00) . . . . . . . . . . . .	$_________

(Note: Contributions greater than the minimum dues are considered a donation and are tax-deductible)

q	Observatory Endowment Fund . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .	$_________
q	Miscellaneous Donations . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .	$_________

(Note: Contributions to these funds are tax-deductible. Indicate amount of donation)

TOTAL ENCLOSED

(From all categories above) . . . . . . . . . . . . . . . . . . . . . . . . .

$_________

Make Check or Money Order to:

GRAND RAPIDS AMATEUR ASTRONOMICAL ASSOCIATION (or GRAAA)

Mail to: Jerry Persha, GRAAA Treasurer
199 Smith St.
Lowell, MI. 49331-1374