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RAS Membership
Gift Membership Form
Note: Information provided here will not be shared or used for any purpose other than what is implied here.
Giver's Information
Gift is from:
(For salutation on card)
Name:
Street:
City:
State:
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
Washington D.C.
West Virginia
Wisconsin
Wyoming
ZIP:
Home Phone:
Email Address:
Send package to:
Giver's address
Member's address
Occasion:
-- Select one --
Birthday
Anniversary
Christmas
Hannukah
Valentine's Day
Father's Day
Mother's Day
Other
(For the card)
Special message:
(2 lines, up to 40 characters each.)
A bill will be sent to the above address for the
dues
.
Note that renewal rates and new member rates may be different.
New Member's (Gift Recipient's) Information
Name:
Street:
City:
State:
Alabama
Alaska
Arizona
Arkansas
California
Colorado
Connecticut
Delaware
Florida
Georgia
Hawaii
Idaho
Illinois
Indiana
Iowa
Kansas
Kentucky
Louisiana
Maine
Maryland
Massachusetts
Michigan
Minnesota
Mississippi
Missouri
Montana
Nebraska
Nevada
New Hampshire
New Jersey
New Mexico
New York
North Carolina
North Dakota
Ohio
Oklahoma
Oregon
Pennsylvania
Rhode Island
South Carolina
South Dakota
Tennessee
Texas
Utah
Vermont
Virginia
Washington
Washington D.C.
West Virginia
Wisconsin
Wyoming
ZIP:
Home Phone:
Do not publish phone number in member contact list.
Type of Membership:
Individual
Family
Student* (Full-time)
Email:
Member's Experience:
Beginner
Intermediate
Expert
After submission, you will be contacted by our membership director.
For questions or more information, contact the
Membership Director
.
* We classify a full-time student as one who is devoting 20+ per week to a formal education program.
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Riverside Astronomical Society, Inc., PO Box 21264, Riverside, CA 92516-1264
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