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Modulo
di iscrizione IDA
Compilare e spedire per posta
o Fax a: International Dark-Sky Association Quota Annuale/Annual Membership:Tipo Quota: Member Sponsor Supporter Sustainer Patron Lifetime Govern. Singolo: $30 * $50 $100 $200 $500 $1000
Associazione: $100 ** $200 $500 $1000 $2000 $3000 $200***
* Studenti (o "Limited Income Individual Membership") $15
** Small (less than 100 members) Astronomy Club Membership $50
*** Offers special resources and services to governmental and utility company members. Nome/Name
o Associazione/Organization: _____________________________________________________________ Indirizzo/Address:
_____________________________________________________________ ______________________________________________________________ Tipo
di quota/Dues Level: ________________________________________________
Compilare nel caso di
pagamento con Carta di Credito: Numero
della Carta/Card Number: _________________________________________________ Tipo
di Carta/Card Type (Visa o MasterCard): _________________________________________________ Data
di scadenza/Expiration Date: _________________________________________________ Firma/Your Signature: _________________________________________________ |
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