Club Membership Registration Form

Membership Registration Form
Name*

First NameLast Name
E-mail*
example@example.com
Phone Number*
Address*

Street Address

Street Address Line 2

CityState / Province

Postal / Zip Code
Astronomical Leaugue Quarterly Newsletter 'The Reflector' Preference:*
Memberships*
prevnext( X )
Single MembershipEnter description
$20.00 Quantity



Family Membership
$30.00 Quantity



Student/Senior Membership
$15.00 Quantity



Subtotal

$0.00

Tax

$0.00

Total

$0.00
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