ASTRE

                        MEMBERSHIP APPLICATION

   I hereby apply for membership in ASTRE.  I pledge to conduct all my
   sport rocketry activities in compliance with the NAR Safety Code.
 
   Note: If this is a renewal, only (*) items need to be filled out.
     Other items may be filled out for updating info.


   Name(*)  _____________________________________Today's Date(*)______________

   Address  __________________________________________________________

            __________________________________________________________

   City     _____________________________________  State _____________

   Zip code ________________________

   Phone number(*)  __________________________

   Email address(*)  __________________________

   Date of Birth  __________________________

   NAR number     ________________     Tripoli number ________________


   Please check off the following as applicable:

   [ ] New membership   [ ] Renewal(* and appropriate member level info)



     ( ) Junior member (under age 18) - $5.00 dues

     ( ) Senior member (18 and over)  - $10.00 dues
 
     ( ) Family membership, primary member - $15.00 dues for entire family
 
           Name: _________________________________________

         Additional family members - no additional dues

           Names: ___________________________________________________

                  ___________________________________________________

       
   Please mail your completed application(s), including a check payable
   to "ASTRE" to:

   ASTRE Membership
   c/o Ray Bedard
   6 Friar Tuck Way
   Saratoga Springs, NY 12866