ST. LOUIS ASTRONOMICAL SOCIETY

Membership Form 

Membership Category

____ FAMILY MEMBERSHIP @ $40.00 / 1 YEAR

$____________

____ ADULT MEMBERSHIP @ $25.00 / 1 YEAR

$____________

____ YOUTH MEMBERSHIP @ $10.00 / 1 YEAR

$____________

TOTAL ENCLOSED 

$____________

First Name _______________________________________ 

Last Name _______________________________________

Address _________________________________________

________________________________________________

City ____________________________________________

State ____________________ Zip Code _______________

Phone___________________________________________

Email ___________________________________________

Please send completed form with check made payable to:

St. Louis Astronomical Society (no cash please) 

and mail to:

Don Ficken, Membership
Saint Louis Astronomical Society
13024 Barrett Crossing CT
St. Louis, MO 63122