CHAOS

Chapel Hill Astronomical and Observational Society Membership Form 

Please print this form using your browser's Print command then complete it and mail it, along with payment (if any, checks may be made payable to "CHAOS") to:

CHAOS
P.O. Box 842
Chapel Hill, NC 27514-0842

ONLY ONE FORM PER HOUSEHOLD IS REQUIRED.

Purpose of Form: __ New Member __ Renewal __ Information update

New member: How did you first hear about CHAOS? ___________________________________

Name(s): _____________________________________________

Address: _____________________________________________

______________________________________________

Phone: (Day)_____________________ (Eve)__________________

Email: __________________________ Website ? url: _______________________________________

EXPLANATION OF FEES: Club membership is $25 for one year.  (Note: At this time we do not offer “family” memberships, but members of your family may attend many events without being members of the club.)

If this is a new or renewal membership, how many memberships are you paying for?
                                                                                ___ Year memberships @ $25

TOTAL ENCLOSED: $__________
Please give a brief description of the astronomy equipment you own:

_____________________________________________________________

_____________________________________________________________

Do you wish to be listed in our membership directory, to be distributed in hard copy to the members?

Y ____ N _____
Comments: ____________________________________________________

______________________________________________________________

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