Membership Form

Date of Application
First	Last	Phone
Address
City	State	Zip
e-mail address
New or Renewal?
Single $15.00 ____	Family $20.00 ____	Senior (60+)/Junior (-18) $10.00 ____
Would you prefer to get your newsletter by e-mail (color, faster, cheaper!)? _______
How did you hear about us?

Please list your interests and possible meeting topics you would like to see at the bottom of this form.

Please print send this form with payment (checks payable to GSAS) to

Susan Welenofsky
13510 Northcreek Drive, # E405
Mill Creek, WA 98012