MUTUAL UFO NETWORK  -  MUFON 
                           APPLICATION FOR MEMBERSHIP 
                              Annual Mem Fee: $25 

    Name _________________________  Age ______  Occupation ________________

    Address __________________________________  City ______________________

    State ______________________  ZIP code ____________  County ___________

    Country ____________________  Telephone: Home (   )____________________
    
                                             Work (   )____________________
    Please enter your highest formal
    educational level or degree ___________________________________________

    Other fields of specialized training __________________________________
    
    Are you an Amateur Radio Operator? __________  Call Letters ___________
    
    Do you have a Citizens Band radio? __________  Call Letters ___________
    
    List other UFO organizations to which you belong ______________________
    
    What is your prime interest in the study of the UFO phenomenon? _______
    
    _______________________________________________________________________
    
    Have you concentrated your research to a category? ____________________
    
    If so, what is your specialized field of expertise? ___________________
    
    _______________________________________________________________________
    
                                                    Model of
    Are you an amateur astronomer? _______________  Telescope _____________


    Considering  your interest,  education,  experience,  occupation,   and 
    available  personal time,  in which capacity do you feel that you could 
    best serve MUFON in UFO research or investigations? 

                Consultant ______                          Astronomy ______ 
            State Director ______            Contributing Subscriber ______ 
    State Section Director ______             Amateur Radio Operator ______ 
        Field Investigator ______          UFO News Clipping Service ______ 
       Research Specialist ______         Field Investigator Trainee ______ 
                                     
                                       
   
    Date ____________________  Signature __________________________________

    ***********************************************************************

    Appointed to the position of __________________________________________

    and ____________________________________________  on __________________
    
                                                             (date)
                                            Annual Membership
    Membership Card Issued ________/______  Dues Received _________________
                           (date)   (amount)
    
    Your State Section Director is:         for: Adult [   ]  Student [   ]
    
    _______________________________              JOURNAL Subcription  [   ]
    
    _______________________________
    
    _______________________________
    
    Your State or Provincial Director:      Approved by ___________________
    
    _______________________________               Walter H. Andrus, Jr.
                                                  International Director
    _______________________________               Telephone: (512) 379-9216
    
    _______________________________               PLEASE SEND TO:         
                                                  ---------------
                                                  MUFON                    
                                                  103 Oldtowne Road        
                                                  Seguin, Texas 78155-4099 
    _______________________________________________________________________