Central Appalachian Astronomy Club

P. O. Box 1862, Clarksburg, WV 26302

Web Site: www.caacwv.com

MEMBERSHIP APPLICATION

The purpose of our club is to promote amateur astronomy through fellowship, observing the heavens and by presenting interesting educational programs and events about astronomy and related fields. Our club is a member of the National Astronomy League. Regular Membership* is open to all individuals 16 years of age or older. Family Memberships ** includes immediate family only (no age requirement but anyone under 16 must be accompanied by an adult). Our meetings are held at the Gaston Caperton Center of Fairmont State College on the New Moon Saturday of each month at 6:00. After each regular meeting (weather and sky conditions permitting) we will have sky observing at our dark sky location, the Good Hope Observatory. By joining, members agree to abide by club rules and bylaws as established by the club membership.

Amount paid $_________ Date ____________ Check number __________ Received by_________________________

(If paying cash in person)

Keep this portion for your records

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Cut on dotted line. Return this part to Central Appalachian Astronomy Club with check or money order to address above.

Membership Enrollment Form: Please print legibly!

Membership type? (Check one): Individual / regular* - $20 ____ OR Family ** - $25 ____ Enrollment date ___________

Make checks payable to Central Appalachian Astronomy Club

Note: Full dues are assessed for new members enrolling through August 31 of each year. Members enrolling September 1 and after will be assessed half the normal rate. Dues are on a calendar- year basis and should be paid on or before January 1 of each year.

(If under 18)

Regular Member Name (last)______________________________ (first) ____________________________Age ______

Family Member Name (last)______________________________ (first) ___________________________ Age ______

Family Member Name (last)______________________________ (first) ___________________________ Age ______

Family Member Name (last)______________________________ (first) ___________________________ Age ______

Please list any additional family members and age on back of form, and check here: ____

Street Address _____________________________________________________________________________________

City__________________________ State _______ Zip ____________ E-mail___________________________________

Home Phone ________________________ Work Phone _______________________ Cell Phone____________________

Type of observing equipment owned ____________________________________________________________________

* Each individual / regular membership has full voting privileges and is entitled to attend all club activities and meetings.

** Each Family Membership includes one regular membership and each enrolled family member is an associate member which is non-voting, but is entitled to attend all club activities and meeting. An adult must accompany (Children under 16 years of age at all times.)

Revision 20030115