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ST. LOUIS ASTRONOMICAL SOCIETY Membership Form |
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Membership Category
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____ FAMILY MEMBERSHIP @ $40.00 / 1 YEAR |
$____________ |
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____ ADULT MEMBERSHIP @ $25.00 / 1 YEAR |
$____________ |
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____ YOUTH MEMBERSHIP @ $10.00 / 1 YEAR |
$____________ |
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TOTAL ENCLOSED |
$____________ |
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First Name _______________________________________ Last Name _______________________________________ Address _________________________________________ ________________________________________________ City ____________________________________________ State ____________________ Zip Code _______________ Phone___________________________________________ Email ___________________________________________ Please send completed form with check made payable to: and mail to: Bill Winningham, Treasurer
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