Friends of Goldendale Observatory

Membership application
Please Print clearly

I would like to be a Friend of the Goldendale Observatory:

Name: ________________________________________________________________________

Address: _______________________________________________________________________

City: ___________________________ State: _________________ ZIP Code: _____________

Phone Number: _(____)________________________________

Email Address:_______________________________________

Date: ____________ Renewal? (Y/N): __________

___ Individual

$10

____ Family

$15

(List First Names of Family Members)

______________________________________

______________________________________

______________________________________

______________________________________

____ Sustaining

$50-99

____ Contributing

$100-249

 

 

____ Patron

$250+

Please make check payable to : Friends of Goldendale Observatory.
Send to : Treasurer, Friends of Goldendale Observatory
c/o Goldendale Observatory State Park
1602 Observatory Drive
Goldendale, WA 98620