WSCAPES Membership Form
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Please fill in your name and address:
* Required Fields
Name
*
Address
*
City, State Zip
*
Phone
*
Fax
Email
Please Check Only One
Do you receive the
Aquascape Lifestyles
magazine?
Level of
Membership Desired
Amount
To
Send
No
Active Member
$49.95
Yes
Active Member
$35.00
No
Honorary Member
$19.95
Yes
Honorary Member
You are already an Honorary Member.
No
Club Supporter
$15.00
Last Updated 3/5/2004
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