| Mission Valley Astronomy Club Membership Application |
| ___________________________________________________________________________________________________ |
| Please Print |
| DATE: Primary Member Name: Occupation: Family Members That will be attending club activities Name: Name: Name: Name: |
| CONTACT INFORMATION Mailing Adress: City: State: Zip: Phone: E-mail: Your Web Site URL: |
| Areas of Interest [ ] Deep sky objects [ ] Comets/Meteors [ ] Planetary/Lunar [ ] Variable/Double Stars [ ] Sun/Solar [ ] Other: Leavel of Experience [ ] Beginner [ ] Intermediate [ ] Experienced [ ] Professional |
| TYPE OF TELESCOPE(S) OWNED |
| To print this application click FILE on you tool bar and click print. Please include $5.00 anual dues and mail to: MVAC memership, c/o Leonard lahaye Sr., P.O. Box 630064, Ravalli, MT 59863. Please make check or money order payable to Leoanrd Lahaye Sr. |
| To print this application, click File on your tool bar and click print. |