Name:___________________________________
Address:________________________________
_______________________________
Phone:(Hm)______-______-_________
Phone:(Wk)______-______-_________
Birthday:________________________
Email Address:___________________
Special Interest:
(i.e.,bird watching,etc..)_____________________________________________________
I/my family would be interested in participating in an
astronomy related mentoring program [ ]
I/my family would like to attend a training session
in the East Dome [ ]
Date:_______________
Annual Dues are $30.00 Regular MembershipBring to a meeting or email the application to us at stargazer411@earthlink.net Our Mailing Address is: Fort Bend Astronomy Club, P.O. Box 942, Stafford,Texas,77497-0942.