Name:____________________________________________

Contact Information: please supply at least one contact address for meeting notification.
 

Residential Address	Business Address
	Company:
Street:	Street:
City: State: Zip:	City: State: Zip:
Phone: (       )	Phone: (       )
Fax: (       )	Fax: (       )
E-mail:	E-mail:

Please circle which address and the method we should use to get meeting announcements and other chapter information. Please remember that email is cheaper and easier for the chapter officers and more timely for you than snail mail.

1. Residential     or     Business                 2. Mail     or     Phone     or     Fax     or     Email
 

Your contact information will be used for official chapter business only and won't be disclosed to others without your permission.

Your membership application for this year is not complete until your dues are paid. You may return this completed form and pay your dues to any chapter officer listed below. Please make checks payable to "AMS-Wright Memorial Chapter".

Pete Roohr, President                 Harm Visser, Vice President             Mike Abel, Treasurer
 

Please answer the following:

1. Member of the American Meteorological Society?     yes     no

2. Like to help judge science fairs?     Yes     no

3. Want to present a talk to the chapter?     Yes     no