A.A.O.B.C. Membership Application

Today's Date: _______________________ Sponsored By : ________________________________________

Name: ___________________________________________________________________________________

Date Of Birth:_____________________________________ AGE:____________

Spouse's Name:____________________________________

Children's Names: _________________________________________________________________________

Home Address: ___________________________________________________________________________

City: ________________________________________________ STATE: ________ Zip: _______________

Home Phone: __________________________ Cell Phone: ________________________________________

Profession: ________________________________________

Internet Access: Yes / No                Your E-Mail address: _________________________________________

Internet Connection Type:                28.8 / Cable            OTHER ___________________________________

ASTRONOMY RELATED EQUIPMENT THAT YOU OWN

Telescope / Binoculars _____________________________________________________________________

Video or CCD equipment ____________________________________________________________________

TELL US ABOUT YOURSELF

Other clubs or exposure to Astronomy? ________________________________________________________

What are your astronomical interests? _________________________________________________________

AAOBC has INTERNET email available to all members and members of your family.

Please enter the desired email that you would like to have activated.

Your email will be username @ AAOBC.COM

AAOBC Desired Email Name(s): _____________________________________________________________

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