NATIONAL COUNCIL FOR GEOCOSMIC RESEARCH

Application for Membership

Name: _____________________________________________________________________________

Address____________________________________________________________________________

City _______________________ Country: _____________

Phone _________________________

E-Mail ___________________________________

 

Membership dues annually are:

All Other Countries: Single Membership $55.00

 

credit card info:

Name on Card: __________________________

MasterCard/VISA: __________________________ Exp. Date: _______

I wish to be affiliated with the following chapter: TURKEY

 

 

Send To:

Linda Fei
Membership Director
1359 Sargent Ave.
St. Paul, MN. 55105
membership@geocosmic.org
(651) 698-1691