This page was designed using Cascading Style Sheets (CSS), and looks best in a CSS-aware browser. Unfortunately yours is not. However, the document should still be perfectly readable, since that's one of the advantages of using CSS.

The Ventura Gem & Mineral Society, Inc. (VGMS)

Membership Application.
DUES:
Initiation Fee-$5.00 (1st year only) Plus:
Single - $20.00 / Couples (one bulletin)-$30.00,
18 years and under with parent-No Charge,
Students / 18 years plus (12 units)-$17.00,
12 / Under considered Pebble Pups-No Charge.

Name(s) (Include Pebble Pups):

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________

_______________________________________________________________________		 Birth Date
(Mo & Day):

________________

________________

________________

________________

________________

________________

Address: ________________________________________________________

City: _________________________________________  State, ZIP: _________________________

Phone(s): __________________________________________________  Date: ___________________

E-mail: ___________________________________________________

Interests:

___ Fossils   ___ Prospecting   ___ Lapidary   ___ Faceting   ___ Mineral Collections

___ Field Trips   ___ Jewelry Making   __ Gem and Mineral Shows

___ Other - Explain _________________________________________________

___________________________________________________________________

___________________________________________________________________

Please return to:
Ventura Gem and Mineral Society, Inc.,
Membership Secretary,
PO Box 1573,
Ventura, CA 93002.

Use your browser's BACK button or equivalent to return to your original page.