Planetary Studies Foundation: Membership Form

Planetary Studies Foundation

To become a member of the Planetary Studies Foundation, a non-profit educational organization:

1. Print this page.
2. Fill out the form.
3. Mail the completed form along with your check to the address provided below.

Membership Form

Regular Member .......____ $ 20.00 for 1 year or ____ $ 35.00 for 2 years
Family Membership.....____ $ 35.00 for 1 year or ____ $ 60.00 for 2 years
Sponsoring Member.....____ $ 50.00 for 1 year or ____ $ 90.00 for 2 years
Contributing Member...____ $100.00 for 1 year or ____ $180.00 for 2 years
Life Member...........____ $500.00
Student Member........____ $10.00 for 1 year

* Must present valid Student ID from an accredited institution. *

PLEASE PRINT

Name: ___________________________________________________________________

Address:__________________________________________________________________

_________________________________________________________________________

City: _____________________________________________________________________

State: ____________________________ ZIP:____________________________________

Phone: ___________________________________________________________________

Email Address: ____________________________________________________________

PLEASE MAIL TO:
PSF Membership
10 Winterwood Lane, Unit B
Galena, IL 61036