SPAACSE -- Member Sign-Up Form

For now, you can fill in the following membership information and eitherpress the SUBMIT button to email it to us or print it out and snail-mailit to us!

The SPAACSE membership fee is $50 (US) or more for corporate members, $25 (US) for general members and $15 (US) for student members. Please allow 4-6 weeks from receipt of funds for delivery of membership package.

The only required fields below are your name, mailing address, and membership type, but we'dappreciate as much information as possible!If you submit your information electronically, you MUST include a validpostal address so that we can send you the proper sign-up information, includingthe request for membership fees.If you print this form and send to us, please include a check, money order, or cashier'scheck (NO CASH PLEASE!) payable to "SPAACSE".

Name:
Mailing Address:
Membership Type:	Corporate Membership ($50 Minimum Donation) General Membership ($25) Student Membership ($15)
NOTE:	All other data is optional, but we appreciate your input!
eMail:
Phone (home):	-
Phone (work):	-
Phone (FAX):	-
Employer:
Profession:
Highest degree or current major:	Graduated?
If given the chance, would you fly in space?	Yes -or- No
What should be done to help improve space education and get the public excited about space exploration?
What type of Member Services would you like to see provided by SPAACSE?
What types of events/activities should SPAACSE sponsor in order to help educate the general public about space?
Hobbies/special skills:
Main Space Interests:
Favorite celebrities:
Favorite sports:
Artistic Interests:
Comments/Additional Information: