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Santa Cruz Astronomy Club Membership Enrollment Form

Name:_____________________________

Address:___________________________

City,ST,Zip:________________________

Telephone:_________________________

Date:_________________________

May your phone number be included on a membership list made available to active members only? [  ] Yes    [  ] No

  [  ] New Member    [  ] Renewal

Membership Category:
[  ] Patron ($65+) [  ] Contributing ($35-60)
[  ] Sustaining ($21-35) [  ] Family or Individual ($20)

  [  ] Do you own a telescope?
      What kind?______________________

Optional:
To help the club better serve its members, we would appreciate your completing the questions below.

Is this your first astronomy club?  yes___      no___

Other club _______________________________

Your primary interests:
  [  ] Learning astronomy basics
  [  ] Learning the Constellations
  [  ] Learning about equipment options
  [  ] Learning observing techniques
  [  ] Astrophotography
  [  ] Telescope making
  [  ] Group observing expeditions
  [  ] Attending club lectures
  [  ] Other________________________________

Would you describe yourself as...
  [  ] Novice  [  ] Intermediate  [  ] Advanced

Email address:________________________________

If you'd like to join the Santa Cruz Astronomy Club, please print, and fill out this form, and mail it with a check to the address below...