LUBBOCK AREA GROTTO APPLICATION FOR MEMBERSHIP ( ) New Member   ( ) Renewal    Original Date joined: __/__/__   Today's Date: __/__/__

Name: ____________________________________________     Date of Birth: __/__/__
Address: _______________________________________________________________
City: ____________________________________     State: _____     Zip: ___________
Home Phone: (___) - ___ - ____     Work Phone: (___) - ___ - ____
E-mail: _________________________________________________

Emergency Contacts and Phone Numbers:
    1. _____________________________________________________  ____________
    2. _____________________________________________________  ____________

Special medications required, medical conditions, and/or known drug allergies:

Are you a member of the National Speleological Society?
    ( )Yes  ( )No   If Yes, Date joined: __/__/____ NSS#: ________

Are you a member of any other Grotto?  ( )Yes     ( )No
    If yes, which grotto do you consider to be your primary grotto? _________________

Rules of the NSS prohibit grotto members from holding any office in their grotto unless they are members of the NSS.  NSS membership includes a monthly caving magazine, a yearly directory, and several special annual and biannual publications related to caving worldwide.  In addition, NSS members may purchase books and publications from an NSS source at special discounts.  Grotto members who are also members of the NSS help their grottos by providing additional voting power on special issues as they arise.  Would you be willing to join the NSS as a member of the Lubbock Area Grotto?  ( )Yes  ( )No  NSS membership forms are on file at LAG.

Dues and Applications need to go to the LAG Secretary/Treasurer:  Brian Alger, 3403 89th St, Lubbock Tx, 79423.  Checks made payable to LUBBOCK AREA GROTTO.

Lubbock Area Grotto dues are $10/year for an individual or $15/year for a family membership and are due by January 1st of each year.  Full dues are collected from January through June 1st.  Dues become $5 for individual or $10 for family after June 1st for new members only.

Lubbock Area Grotto meetings are generally held on the first Tuesday of each month at members homes that are willing to host. Meetings begin at 7:00 P.M.

Signature: ____________________________________  Date: ___________________