MAC - New Member Form

JavaScript isn't enabled in your browser, so this file can't be opened. Enable and reload.

Thank you for your interest in joining the Midlands Astronomy Club! Please provide the following information below.

Basic Information

First Name *

Last Name *

Address *

City *

State *

Zip *

Email Address *

Phone Number

Membership Level *

Individual $25.00 / year

Family $35.00 / year

Student $10.00 / year

Payment Method *

I will pay in person at a meeting.

I will be mailing a check (make payable to Midlands Astronomy Club).

I will pay online via PayPal.

If joining as a Family, please include the names of your additional family members and their relation to you:

Please tell us how you learned about the Midlands Astronomy Club:

You will be automatically added to the club's general email distribution list; however, we have two additional lists that may interest you:

"SHNOBS" - SHort Notice OBServing sessions. This list may be used to announce pop-up observing sessions at one of our dark-sky locations if the weather forecast looks good.

"OUTREACH" - Outreach sessions. This list may be used to keep members up to date on special outreach observing requests. We always need volunteers to help out at these events, and they're fun, too!

Please choose any additional emails lists you would like to be added to:

SHNOBS - SHort Notice OBServing sessions.

OUTREACH - Outreach sessions.

Thank you for joining the Midlands Astronomy Club! You should receive an email from one of our club officers soon. In the meantime if you have any questions, please email us at SCMidlandsAstronomyClub@gmail.com.

Submit

Clear form

Never submit passwords through Google Forms.

This content is neither created nor endorsed by Google. Report Abuse - Terms of Service - Privacy Policy

Forms