ANTIQUE TELESCOPE SOCIETY INC.

ANTIQUE TELESCOPE SOCIETY INC.

AN INTERNATIONAL SOCIETY
MEMBERSHIP APPLICATION
Name

First NameLast Name
Address

Street Address

Street Address Line 2

CityState / Province

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MY PARTICULAR INTEREST IN ASTRONOMY, OR INSTRUMENTS THAT I OWN (OPTIONAL)
INDIVIDUAL & CLUB MEMBERSHIPS
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Regular membership1 year membership
$20.00 one-time payment



2 year membershopsave 10%
$36.00 one-time payment



3 year membershipsave 16%
$50.00 one-time payment



Non-profit membershipsave 16%
$30.00 one-time payment



Contributing sponsorshipSponsors receive one vote with the same privileges as a Regular Membership. A portion of the Sponsorship will be considered dues and the rest a charitable contribution.
$100.00 one-time payment



Sustaining sponsorshipSponsors receive one vote with the same privileges as a Regular Membership. A portion of the Sponsorship will be considered dues and the rest a charitable contribution.
$250.00 one-time payment



Benefactor sponsorship Sponsors receive one vote with the same privileges as a Regular Membership. A portion of the Sponsorship will be considered dues and the rest a charitable contribution.
$500.00 one-time payment



Additional contribution
USD for each year

Recurring payments



Total

$0.00
If you prefer to mail in your application and payment download the PDF form, complete the form, and mail it along with a check (in US funds) made out to:

Antique Telescope Society
c/o Peter Bealo
82 Sweet Hill Road
Plaistow, NH 03865 USA
Should be Empty: