North Central Kansas Astronomical Society Membership Application

 

Please print this form, fill it out, and mail it in with your payment to:
North Central Kansas Astronomical Society
3711 Birch CT, Manhattan KS 66503
 

At NCKAS, we value our members!  Benefits of membership include monthly meetings, workshops, use of NCKAS telescopes, informative email notices, and monthly star parties. Plus you’ll have access to the NCKAS Members-only section of our website, and admission to any event!

 

Yes, I’d like to _____ become a new member  or _____ renew my membership for this year.

 

Choose a membership level: (Memberships are pro-rated from Jan 1st -Dec 31st)

Renewal

New
Jan-Mar

New
Apr-Jun

New
Jul-Sep

New
Oct-Dec

 

$30

$30

$22.50

$15

$7.50

Individual Membership

$6

$6

$4.50

$3

$1.50

Student Membership

$40

$40

$30

$20

$10

Family Membership

 

$______ Member - $30 full year, pro-rate schedule above
$______ Student - $6 full year, pro-rate schedule above - Please include copy of student I.D.
$______ Family - $40 full year, one household, pro-rate schedule above – Include names of all members.
$______ Supporter - $75 per year, all benefits of a family membership, plus you support NCKAS!
$______ Contributor - $150 per year, all benefits of a family membership, plus you support NCKAS!

-Plus-

Additional Tax Deductible Donation... Amount $__________ - You can take advantage of our non-profit foundation for a tax-deductible donation of money or equipment. Your equipment will be appraised at fair market value and a receipt for that amount. Please make your Tax Deductible donation check out to: NCKCN Foundation, Inc./NCKAS

 

Member Information: 

Name(s) _____________________________________________________________________________
ญญ                                                                        (please list names of all members covered by family membership)

Address _______________________________________________

City ___________________________  Zip____________________ 
Telephone ______________________________________________
E-mail Address(es) _____________________________________________________________________

_____ Yes, I would like to have my email address listed on the NCKAS Members-Only List.

_____ No, I do not want NCKAS to contact me via email.

 

I agree to abide to the terms and conditions* governing use of NCKAS property. I understand that failure to abide can result in revocation of use privileges and NCKAS membership.

 

Signed _______________________________________________ Date ______________

 

*A copy of the NCKAS Constitution is available on the NCKAS website, www.nckas.org,  or by contacting the NCKAS Secretary.