CSSS Membership Form

To become a member of the Chicago Society for Space Studies, either:

Fill out the online form below and click the Join CSSS button.

Or

Copy the printable form at the bottom of the page and paste it into an email or a document, fill it out and either email or mail it to the designated address.  If you are making a voluntary donation, then mail the completed form along with your check to the address provided at the bottom.

If you prefer, you can copy and paste the following form into an email or document for mailing.

Chicago Society for Space Studies Membership Form

___ Yes, I want to support the educational activities of the
    Chicago Society for Space Studies by becoming a member.

___ Yes, I am also interested in funding space education and am
    including a check payable to CSSS for construction of the CSSS
    Lunar Display. Enclosed is a check made payable to the
    Chicago Society for Space Studies in the amount of:

    $_________________________

Please complete the following membership information:

Name:   _____________________________________________________________

Address:_____________________________________________________________

        _____________________________________________________________

City:   _______________________________________________

State:  ____________  ZIP:___________________________________________

Phone:  _____________________________________________________________

Email Address: ______________________________________________________

If sending a donation, please return this form and your check made payable to the Chicago Society for Space Studies to:

          Chicago Society for Space Studies
          700 Cape Lane
          Schaumburg, IL  60193

Thank you for supporting the Chicago Society for Space Studies and our educational mission.