EVAC Electronic Membership Application

While remitting payment electronically is convenient, it does not allow the club to obtain the same member information collected with the traditional membership application. To help ensure our database is complete, please take a moment to complete the online membership application form below before proceeding to either the PayPal payment page or your bank's online bill-pay page. Your application cannot be processed without this information.
Thank you for your cooperation!

Select one:             New Member               Renewal               Update Information 

Indicate the method of payment you will use:     PayPal          Bank's Online Bill-Pay

Indicate the total amount of your payment: $      Date of payment:    

Name:

Address:

City:    State:    Zip Code:

Phone:

Email:    Publish on website

URL:

Delivery method for monthly newsletter:   Electronic delivery (PDF)            US Mail

Sky & Telescope Customer ID #:      Astronomy Customer ID #:

Areas of Interest (check all that apply):   General Observing     Lunar Observing     Planetary Observing    

Archaeoastronomy   Telescope Making     Astrophotography     Deep Sky Observing    

Cosmology     Other 

Do you currently own astronomy equipment?     Yes     No

If yes, please describe:

Would you be interested in attending a beginner's workshop?     Yes     No

How did you discover EVAC?  

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