To join the American Littoral Society, please print out this page and mail it back to us at: American Littoral Society, Northeast Chapter, 28 West 9th Road, Broad Channel, NY 11693, or email us.for more information.

Please enroll me as a member of the American Littoral Society and send current issues of Underwater Naturalist, Coastal Reporter, Littorally Speaking, and a membership card.

I enclose a check for $______ for the membership type checked below: __ $25 Senior __ $35 Individual/Family __ $40 Library __ $50 Club __ $55 Foreign __ $50 Sustaining Member __ $100 Supporting Member __ $250 Advocate __ $500 Littoral Leader __ $___ Other (more than $500) __ $___ Gift membership (information on right)

Or you may charge your membership fee: (Check one) __ VISA __ MasterCard Card Number __________________________ Expiration Date _________________________ Signature ______________________________

Contributions are tax deductible. Payment in U.S. funds only. Make check payable to American Littoral Society.

Applicant:

Name _____________________________________________________________

Address __________________________________________________________

City _____________________________________State ________Zip ______

Gift Recipient:

Name _____________________________________________________________

Address __________________________________________________________

City _____________________________________State ________Zip ______

Use the box below if you want to send a short greeting to a Gift Recipient.

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