Note: You will be asked to print and mail this form once you have filled
it out. If any of your responses don't fit completely in the boxes, they may
not visible when they are printed. Please complete them by hand after printing.
Do you wish mailings sent to your home or office?
Do you wish your phone number published in a membership directory?
Do you commonly attend the national meetings of any professional societies?
Geological Society of America
American Association of Petroleum Geologists
American Geophysical Union - Fall
Would you be interested in attending a meeting of the Affiliation of Christian
Geologists held in conjunction with any of these national meetings?
Are you a member of the American Scientific Affiliation?
Please consider my application for membership in the affiliation of Christian
Geologists as a Regular
, or Associate
Member. I am in agreement with the statements of Purpose and Principles.
Amount Enclosed ($10 yearly dues):
Please print this form (approximately 3 pages) and send dues and application
ACG c/o Keith B. Miller
Dept of Geology, Kansas State University
Manhattan, KS, 66506-3201