LAGLS Membership Application
(print this form out, fill it out, and send it in with your dues payment)

You can support LAGLS and its activities and goals by becoming a member. A membership form is on the other side of this page for your convenience.  You can even join NOGLSTP at the same time if you like. Simply print page out, fill out the form, and mail it via the US Postal Service to LAGLS, PO Box 91803, Pasadena CA 91109. Be sure to take advantage of our 2-for-1 policy: Two people who share an address may become members for the price of one!

• I want to join!  Enclosed is a check payable to LAGLS for (circle one):              $25/year regular         $10/year student

• (Optional) I also want to support NOGLSTP.  Enclosed is a check payable to NOGLSTP for (circle one):    $15/year regular         $10/year student

NAME _________________________________________

ADDRESS______________________________________

CITY___________________________________________

STATE_______  ZIP__________

PHONE_____________________

EMAIL/URL________________________________________________________

SCIENTIFIC DISCIPLINE/ or TECHNOINTEREST:______________________________________________________

WOULD YOU LIKE YOUR NAME, PHONE, AND EMAIL/URL TO BE PRINTED ON A MEMBERSHIP ROSTER TO BE RELEASED TO OTHER MEMBERS?(circle one)                  YES                         NO

MAY WE EMAIL YOU ANNOUNCEMENTS/REMINDERS ABOUT LAGLS ACTIVITIES? (circle one)            YES           NO

HOW DID YOU FIND THIS WEBSITE?

HOW MAY LAGLS SERVE YOU?