COMETS 2009

Membership Application

Send check, credit card number/name of holder/name of credit card company/expiration date/ AND this form to:

COMETS 2009

C/O Lisa Dyer

Truman Education Center

4301 NW Koehler Loop

Fort Sill, OK 73503-9009
Lisa.m.dyer@us.army.mil

Name:__________________________________________

Title:___________________________________________

Organization:____________________________________

Address:________________________________________

_______________________________________________

Phone Number:__________________________________

Fax Number:_____________________________________

E-mail Address:__________________________________

Membership Fee for 2008 $10.00

Total amount enclosed:                          $____________

Method of Payment:

___ Check           

___ Credit Card: Name on Card:_____________________

Account Number: _____________________________

 Expiration Date: ____________Type of Card:________