GARDEN PARK PALEONTOLOGY SOCIETY

Membership Application

  Name_______________________________________________________

  Address_____________________________________________________

  City______________________________ State______ Zip  ____________

  Phone ( ______ )_______________________________________________

  E-Mail Address __      __________________________________________

       [  ]  Individual     $15.00                             [  ]  Supporting        $100.00+

       [  ]  Family         $25.00                              [  ]  Patron              $250.00+

       [  ] Student           $5.00                              [  ]  Benefactor       $500.00+

       [  ]  Senior Citizen (60+)     $7.50

Please make your check payable to:

Garden Park Paleontology Society
330 Royal Gorge Blvd.  #A
Cañon City, CO   81212

Memberships are tax deductible to the extent allowable by law.