YOU WILL BE PLEASANTLY SURPRISED BY THE FUN YOU WILL HAVE !!!!

Maine Mineralogical & Geological Society

Membership Information

Membership Application

Family membership includes children under 18 years of age.Please print out the following form, complete and mail with your check to: Maine Mineralogical and Geological Society, 513 Main Street, Monmouth, Me. 04259-7537

New ___ Renewal___ Membership Number (club use)_________________

Name (Last) _________________________ (First) ___________

Spouse: _____________________________

Street: ________________City_____________ State: ____

Zip _______

Telephone: (___)(___)_______

Please list name and ages of children under 18:
____________________________________________________________________ ____________________________________________________________________ ____________________________________________________________________

E-mail address____________________________________

Family: $17

Individual $12

Dues are for one year (Jan.1-Dec.31)

Make checks payable to MMGS.

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