Blue Ridge Astronomy Club Membership Form

Blue Ridge Astronomy Club Membership Form
www.blueridgeastronomy.org

(Please print this form, fill it out, and mail as described below)

Name: ________________________________________________________

Address: ______________________________________________________

City: _________________________ State: _______ Zip: _________

Phone: ___________________(Home)== ________________(Work)

Email: ________________________________________

Website: ______________________________________

May we publish the above information for all Club members? Yes _____ No _____

Check one: I consider myself . . .

_____ A casual observer - a passing interest and want to learn a little more.
______ A special observer - interested in seeing comets, eclipses or other special events.
______ A general observer - some knowledge of astronomy & some experience with telescopes.
______ A critical observer - have a scope; observe at least monthly; can locate and/or identify many constellations and deep-sky objects.
______ A professional astronomer - lucky enough to earn a living in astronomy.

Rank the following from 1 to 5 in the order of interest (with 1 being the highest interest):

_____ planets _____sun _____moon _____constellations
_____ deep space objects (i.e. clusters, nebulae, etc.) _____ other, please list

I would be interested in attending programs concerning the following topics:

__________________________________ ________________________________ __________________________________ ________________________________

____I would be interested in making a 15-20 minute presentation at a future meeting on the topic: _____________________________________________________

____I would be willing to work on one of the following committees:
____Publicity/Outreach; ____Programs; ____Events/Activities

Membership* Categories:

______ Single - $20 (one vote)===============Amount Paid: _________
______ Family - $25 (two votes)= ============Date: ________________
______ Student - $15 (one vote) K-College
______ Senior - $15 (one vote) 65 and over

*Membership year runs from September through September

Mail your completed form along with a check made payable to "Blue Ridge Astronomy Club" for your first year membership dues to Brian Munson, Treasurer, c/o Blue Ridge Astronomy Club, P.O. Box 441, Forest, VA 24551.