SCAS | Member Registration

First Name

Last Name

Company

Affiliation

Email

Mailing Address

City

State/Province

Zip

Mobile Phone

Phone (other)

Person 1

Person 2

Person 3

Person 4

Please list only family who wish to be members of SCAS and live at the above address.

School Name ( if full-time student )

Grade or Class

What telescope(s) do you own?

Want to help at public events?

Availability

Individual or Family - 1 Year - $25.00
Individual or Family - 2 Year - $45.00
Full-time Student - 1 Year - $10.00
Full-time Student - 2 Year - $18.00

1 Year - $34.00
2 Year - $60.00
No Thanks

1 Year - $43.90
2 Year - $76.90
No Thanks

500 Character Limit