}  WASI MEMBERSHIP DATABASE
New Member Registration Form
Please Fill In All Fields:
	First Name:
	Last Name:
	Job Title:
	Employer:
	Street Address:
	City:
	State or Province:
	Postal Code:
	Country:
	Home Phone:
	Work Phone:
	Extension:
	Date Joined WASI  (Leave blank to insert today's date)	[MM/DD/YYYY]
	Date Last Dues Paid:  (Leave blank to insert today's date)	[MM/DD/YYYY]
	If you were a member before enter the date you left WASI.  And welcome back!  (Or leave blank to insert today's date)	[MM/DD/YYYY]
	Email Address:
	Membership Type:	Member Type Single Family Junior
	Currently A WASI Member:	FALSE
	How do you wish to receive our News Letter?	Receive Mason-Dixon Digitally Receive Mason-Dixon Hard Copy
	Are you a member of Astronomical League?	Yes No
	Do you have anything you'd like to tell us about yourself or your equipment?

Coded by T.P.Milley for WASI!