GMS Membership Application Form Test
Required fields are marked with an asterisk *
Reset Form
*
Membership Type:
New
Renewal
Student
Gift
Check here if you are renewing and don't have any changes
An individual at least 18 years old who is enrolled full-time in a post-secondary educational institution (past high school) can join as a student member. Student membership does not include any family members, and does not include the option of a hard-copy newsletter.
Gift From:
Gift Message:
*Error:
Membership type is required, please select New, Renewal, or Gift
Enter Membership Information for the Gift Recipient
Primary Member
* First Name:
* Last Name:
*Error:
First Name is required
*Error:
Last Name is required
* Email: (Enter N/A if not applicable)
Check here if new email:
Birthday (month/day):
*Error:
Invalid email format
*Error:
Email is required. Enter N/A if not applicable.
*Error:
Invalid birthday -- must be month/day e.g. 01/25 (Note: Birthday is optional for adults)
Phone:
* Zip Code:
*Error:
Zip Code is required even if you are not paying for printed newsletters
Privacy Policy:
Personal information will be used for Georgia Mineral Society communications
only
Address (Note: Zip Code is required)
Address:
( If this a new address check here:
)
City:
State:
* Zip Code:
+ 4:
*Error:
Zip Code is required even if you are not paying for printed newsletters
Privacy Policy:
Personal information will be used for Georgia Mineral Society communications
only
Partner/Spouse
Click "Yes" to enter information or "No" if this section is not applicable to this membership
* Partner/Spouse:
Yes
No
*Error:
You must select "Yes" or "No" for Partner/Spouse
First Name :
Last Name:
*Error:
First Name is required. Select "No" above if this section is not applicable to this membership
Email:
Check here if new email:
Note:
Email address is optional. Please leave the email field blank if you
do not
want to receive GMS email.
Birthday (month/day):
*Error:
Invalid email format
*Error:
Invalid birthday -- must be month/day e.g. 01/25 (Note: Birthday is optional for adults)
Phone:
Privacy Policy:
Personal information will be used for Georgia Mineral Society communications
only
Juniors (Children in the household currently
under
the age of 18)
Click "Yes" to enter juniors or "No" if this section is not applicable to this membership
* Juniors:
Yes
No
*Error:
You must select "Yes" or "No" for juniors
*Error:
Junior 1 is required. Select "No" above if this section is not applicable to this membership
*Error:
Invalid birthday -- must be mm/dd (month/day) e.g. 01/25
*Error:
To qualify as a junior, age must be a valid number greater than 0 and less than 18
*Error:
Age is required for juniors
Jr 1:
Age:
B-day:
Jr 2:
Age:
B-day:
Jr 3:
Age:
B-day:
Jr 4:
Age:
B-day:
Jr 5:
Age:
B-day:
Jr 6:
Age:
B-day:
Jr 7:
Age:
B-day:
Jr 8:
Age:
B-day:
Jr 9:
Age:
B-day:
Other Adults (additional members of the household 18 or older who may participate in club activities)
*Error:
Invalid birthday -- must be month/day e.g. 01/25 (Note: Birthday is optional)
Adult 1:
Birthday:
Show more adults
Adult 2:
Birthday:
Adult 3:
Birthday:
Adult 4:
Birthday:
Calculate Dues
Printed Newsletter?
No ($25/Year)
Yes ($35/Year U.S. Address Only)
*Error:
Printed newsletter preference is required
*Error:
# of Years cannot be less than 1 or greater than 5
# of years (max 5)
Total Dues:
0
Please read the website's
Privacy Policy
and the
AFMS Code of Ethics
, then click the box below so the submit button will appear and you can continue the process.
You must click the box below to get the submit button
I have read the
AFMS code of ethics
and understand that all members of GMS must abide by these ethics.
Step1: Complete the Form and Click the AFMS Code of Ethics Box
Submit
Step2: Verify the Form and Click the Submit Button
Thank you for completing the membership form!
Please verify the payment summary below
Then click a payment method
Or click the form button to return to the membership form
Membership Dues Payment Summary
Membership Type
Gift From
Gift Message
Payment Description
Years of Dues
Total
Back to Form
Step3: Click a Payment Button and Pay for Dues
Thank you for paying membership dues!
Subscribe
*
indicates required
Email Address
*
First Name
Last Name
Birthday
/
( mm / dd )
Please Click Below to Continue to Step 3
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