Membership Form Membership "*" indicates required fields Your Name*First & Last Please A.K.A.If you go by something other than your legal name, please list it here as this will be printed on your name badge for the club. There will be a $5 fee for replacement or updates to names. First Last Spouse's Name Address* Street Address City AlabamaAlaskaAmerican SamoaArizonaArkansasCaliforniaColoradoConnecticutDelawareDistrict of ColumbiaFloridaGeorgiaGuamHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaNorthern Mariana IslandsOhioOklahomaOregonPennsylvaniaPuerto RicoRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahU.S. Virgin IslandsVermontVirginiaWashingtonWest VirginiaWisconsinWyomingArmed Forces AmericasArmed Forces EuropeArmed Forces Pacific State ZIP Code Email* Enter Email Confirm Email Phone*Do you want to be listed in WVAC's (Members Only) online directory?* Yes No Do you want to be added to WVAC's Star Party email list?* Yes No How did you hear about WVAC? Do you own a telescope?If yes, answer the next three fields. Yes No Make Model Aperture Are you interested in volunteering for community outreach (schools, scouts, public star parties, etc.) Yes No Special interests in the field of Astronomy:Would you be willing to present at a club meeting? Yes No In what astronomy topic(s) do you have advanced education, knowledge or experience in:Do you have any contacts that may want to present at a club meeting? Yes No How can we help you.... (select all that apply)* Buy a telescope? Get advice? Learn about Astronomy? Other? Select AllIf other, please explain.CAPTCHANameThis field is for validation purposes and should be left unchanged.