Astronomical Society of South Australia Inc. -------------------------------------------------------------------------------- MEMBERSHIP APPLICATION/RENEWAL FORM -------------------------------------------------------------------------------- Annual membership fees are due before January 1st each year. Members joining after July 1st pay only half rates for the balance of that year. Full Membership $55 --------------- Adult, Family, School or other Institution (family/institution receives one vote) Concessional $40 ------------ Children under 18, full-time student, pensioner, unemployed or country location (>40km from the Adelaide GPO) I wish to receive The Bulletin electronically only and receive -$10 a discount of $10 ($5 after 1st July). Astronomical Yearbook* $20 Starfinder Planisphere* $12 Metal Lapel Membership Badge $10 Sew-on Fabric Logo $10 Navy Blue Baseball Cap* $15 Donations South Australia Telescope Fund $.............. General $.............. *Add $3 for postage & handling unless collecting at a meeting Surname: .................................................... Given Name(s): ............................................. Mailing Address: ............................................ ............................................................. Telephone (optional): ....................................... E-mail Address (optional): .................................. Membership Type: ............................................ What year did you first join? ....... Total Amount Enclosed: $.............. Please tick the following items if you are able to help your Society in any way: I can help at: [ ] schools [ ] Stockport [ ] The Heights [ ] Douglas Scrub [ ] Whyalla I can do: [ ] electrical [ ] plumbing [ ] welding [ ] gardening [ ] other ............................... I can supply discounts on ................................... Once or twice a year, I can help to: [ ] collate the Bulletin [ ] make suppers [ ] I Would like to receive my Bulletin electronically [ ] Subscribe me to ASSA-Chat, the Society's email list [ ] I have my own telescope [ ] I would like information on ............................ Forward the completed application form to: Honorary Secretary Astronomical Society of South Australia Inc. GPO Box 199 Adelaide SA 5001