Florida Academy of Sciences

Florida Academy of Sciences

Application Form - 2018 - Pay By Check

 


 

Your Name:
Address for FAS mailings:
Address Line 2:
City:
State:
Zip:
Phone:
E-Mail:
University Affiliation or Employer:

MEMBERSHIP LEVELS

Regular $35.00 Student $20.00
Sustaining $45.00
Life $500.00
  Patron $1000.00
Corporate $200.00 Institutional $100.00
 

CONTRIBUTIONS

FLORIDA ENDOWMENT for Sciences (a Trust Fund for FAS awards, special projects). $
Dr. Elizabeth A. Hays Travel Award Fund $
Academy Operating Funds $
Please select a FAS section of interest from the list:

Payment Total Amount

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Mail completed form to:

Memberships
Florida Academy of Sciences
P.O. Box 149766
Orlando, FL 32814-9766