Southern Appalachian Mineral Society

Membership Application

	Yes, I Would like to join Southern Appalachian Mineral Society. I have designated the level of membership I prefer and have included my payment. Please start my membership today.
	Renewal
	Individual	$15.00
	Family (adults and children 12 and under)	$20.00
	Junior (ages 13-18)	$ 5.00
	Contributing	$25.00 or more
	(prorated quarterly)
	Please make checks payable to S.A.M.S.
	Name _________________________________________________________________
	Spouse's Name _________________________________________________________
	Children's Names _______________________________________________________
	Address _______________________________________________________________
	City _________________________________State ______________Zip ___________
	Phone ________________________________ E-mail __________________________

	Occupation: ___________________________________________________________
	In what are you unterested?
		Mineralogy	Lapidary
		Field Trips	Geology
		Mining
	What other Hobbies (past or present) _______________________________________
	_____________________________________________________________________
	Birthdays:
	Name (Mo/Day) _______________________________________________________
	Spouse (Mo/Day) ______________________________________________________
	Children (Mo/Day/Yr) ___________________________________________________
	_____________________________________________________________________
	_____________________________________________________________________

Please mail to:	Southern Appalachian Mineral Society
	P.O. Box 15461
	Asheville, N.C. 28813