Discovery Science Center Membership Form

New Member

Renewing Member

Gift Membership

Individual Membership $35 One year	Family Membership (at one address) $70 One year
Grandparent Membership (Grandparents & all grandkids) $60 One year	Deluxe Membership (at one address) $85 One year

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Date
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Adult member name
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Second adult member name
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Address
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City, State, Zip
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Email
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Employer (may provide membership discounts for employees)

Number of adults _____________         Number of Children _____________

Cash

Check

Visa

Mastercard

Discover

Card # _________________________________ Exp Date _____________

Please make checks payable to: Discovery Science Center

Mail this application along with payment to:   Discovery Science Center   703 East Prospect Road   Fort Collins, CO 80525

DSC use only: Entered in database Letter sent Has card     Exp Date________ Member number: ______________