MAS Membership Form

Print this form, complete it, and mail with your check enclosed to the address below.

Name: _______________________________

Address: _____________________________

City/State/Zip: _________________________

Phone: _______________________________

Email: _______________________________

(please supply an email address if you have one)

Please circle membership type:

Student ($5.00)

Regular ($30.00) *

Student Observing ($45.00)

Regular Observing ($70.00) *

(* covers a family at a single address)
Enclose check and make payable to the Madison Astronomical Society
mail to
Jurgen Patau
114 Alden Dr
Madison WI  53705