Current NSMGS membership dues are $20 per family (up to two adults and two children). The dues cover membership from January 1, 2004 to December 31, 2004.
Payment (Circle One): Cheque Cash
Total Amount Enclosed: 
Name of Principal Applicant:
Names of Additional Family Members to be Covered:
Mailing Address:
Telephone: () -
Alternative: () -
Email (If Applicable):
Are you willing to read the bark on the web ( Yes / No ) and/or receive other notices via email ( Yes / No )?
Please circle your areas of interest: Minerals Fossils Gems Lapidary Geology Other ____________________
By submitting this application with payment, the applicant agrees to abide by all conditions of membership as stated in the constitution and releases the Society and its members from any liability associated with Society activities.
I have read and understand the conditions of membership.
Signature:
Signature of parent/guardian if under 18 years of age:
Date: