MISSOURI AQUARIUM SOCIETY FORM FOR MEMBERSHIP OR RENEWAL
Membership is $20 per calendar year and includes a subscription to the club publication “The Darter”.
After June 30, membership for the remaining part of the year is $15.
Membership includes everyone in the immediate household.
(optional) PHONE NUMBER:_____________________________________
1. May we publish this address in The Darter once a year as part of our membership roster? YES/NO (circle one)
2. May we publish your email address? YES/NO (circle one)
3. May we publish your phone number? YES/NO (circle one)
Please print, fill out this form and mail this form and your check to:
6301 Kingsway Drive
JULY 2012, Kathy Deutsch