General Contact Information Renewal This data reflects a change

Name____________________________________________________________________________________

Firm / Library _____________________________________________ Title____________________________

Street___________________________________________________ Suite / Apt_______________________

City______________________________________________________________________________________

State / Province____________________________________________________________________________

Mailing (ZIP) Code__________________________________________________________________________

Nation____________________________________________________________________________________

Telephone________________________________________________________________________________

FAX_____________________________________________________________________________________

email_______________________________@____________________________________________________

Website___________________________________________________________________________________

Membership

Type All memberships include a subscription to Space Governance Journal

Standard $100 per annum

Student Pass $60 per annum Until Baccalaureate plus One Year

Senior Pass $60 per annum Age 60 and above

Buddy Pass $60 per annum USIS Sponsor: __________________________________

Bridge Pass $60 per annum Other Space Org: ________________________________

Subscriptions Only

Space Governance Journal Institutional Libraries please choose an agent:

$20 per issue (currently annual) EBSCO Subscription Services

William S. Hein & Co.

SPACE RFP We prefer direct or:

$25 per issue (currently annual) Other _________________________________

International Space Development Bond

Please send a Prospectus

Please Call Phone other than above ___________________________