Minnesota Aquarium Society Membership Form
Minnesota Aquarium Society
P0 Box 130483
Roseville, MN 55113-0016
http://www.mn-aquarium.org
Today's
date: ____________________
|
Type of Membership:
|
Method of Payment:
|
- Adult$15.00/year
- Family$15.00/year
- Junior$12.00/year
|
Cash ____________
Check (#_________)
|
- Renewal
for _______ years
- New
membership
The following information will not be used outside the
Minnesota Aquarium Society.
Name: _________________________________________________________
Address: _______________________________________________________
City: ______________________State: _______ Zip code: ______________
Home phone:
(______)______________________________________________
E-mail
address: ___________________________________________________
