THE APOLLO SOCIETY
MEMBERSHIP APPLICATION

Please provide the following information:


Name:
__________________________________

Address:
__________________________________

__________________________________

__________________________________


Phone:
__________________________________

Email:
__________________________________

WWW:
_________________________________


Please include any additional information, comments or suggestions:


__________________________________

Please pay annual membership dues at the membership level of your choice.
(choose one level)

(Note: Membership benefits will be based on your membership level and how early you join.)

Mercury = $25.00 . . . . . . . Gemini = $50.00 . . . . . . . Apollo = $100.00

Your membership helps support The Apollo Society's educational, scientific research and technology development programs to advance space exploration and the establishment of human communities beyond Earth. The Apollo Society is a non-profit, tax-exempt, charitable organization federally recognized under US IRS CODE 501c(3). Your dues and donations are tax deductible.

Please send your completed application with your annual dues payment and contributions via check or money order payable to:

The Apollo Society
P.O. Box 61206
Honolulu, Hawaii 96839-1206

The Apollo Society
Membership Program