THE AMERICAN GEOGRAPHICAL SOCIETY
Membership Form (Print and Return)
Fellows of the American Geographical Society play an important role in helping our programs succeed. Your membership as a Fellow will help underwrite Society initiatives in scientific research, exploration, and education.
Full Name _______________________________________________________
Mailing Address ___________________________________________________
City _______________________ State ___________ Zip Code _____________
Daytime phone ____________________ Evening phone ___________________
Fax ___________________ E-mail address ___________________
Annual Dues (2010) for Fellows: $65.00 ______ (Check here)
Annual Dues (2010) for Institutions: $85.00 _______ (check here)
Please indicate the amount of your additional contribution below:
__ $25 __ $50 __ $100 __ Other _______ (Check one for additional contribution)
Method of payment:
__ My check is enclosed, payable to the American Geographical Society.
__ Please charge my credit card:
__ Visa __ MasterCard __ American Express
Acct. Number _______________________ Exp. _________
Tax-deductibility: The American Geographical Society is recognized as a tax-exempt, nonprofit organization under section 501(c)(3) of the Internal Revenue Code. Contributions to AGS are tax-deductible within the limits of the law.
Whether you give by check or credit card, the AGS will send you a printed acknowlegement for tax purposes.Mail or Fax this completed form to: