Membership Application
Name:
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Address:
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City, State & ZIP:
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Phone:
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E-mail:
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Chapter newsletter via email (yes)(no)
National newsletter via email (yes)(no)
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Dues are $15 a year (including National dues),
payable to PNWFM.
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Send application to:
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PNWFM
c/o Bruce Kelley
15791 Bear Creek PKWY, Apt. A542
Redmond, WA 98052-1519
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The following optional information is to help FM better serve you.
Mark any that apply.
Chief interests:
- Display
- Education
- Field Collecting
- Field Trips
- Fossils
- Gems
- Geology
- Lapidary
- Micro Mounting
- Micro/Macro Photography
- Mineralogy
- Other _________________________
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