Membership Application Form

NEW ZEALAND SPACEFLIGHT ASSOCIATION, INC.
PO Box 5829, Wellesley Street, Auckland, New Zealand

MEMBERSHIP APPLICATION
1^st September 2007 - 31^st August 2008

Name:

______________________________________________________________

Postal Address:

______________________________________________________________

Telephone:

________________ E-mail Address: ___________________________

I/We enclose $_____________ as fees for membership of the NZSA.

ORDINARY	SENIOR	STUDENT	(circle one)
$50	$45	$42.50