Big Bend Archeological Society
Membership Application

NAME:  _________________________________________________________________

ADDITIONAL NAMES:  ____________________________________________________

ADDRESS (Street, P.O. Box):  _______________________________________________

CITY, STATE  ZIP:  _______________________________________________________

TELEPHONE (Unlisted numbers remain confidential at your request): _________________

MEMBERSHIP @ $20 PER PERSON:             SELF ________

                                                                             OTHER  ________

                                                                             ADDITIONAL DONATION:      ________

                                                                              TOTAL ENCLOSED:    $_____________

I pledge that I will not intentionally violate the terms and conditions of any State or Federal cultural resource protection laws, regulations, or antiquities codes, as they exist or shall be hereafter amended or enacted, or engage in the practice of buying or selling artifacts for commercial purposes or engage in the willful destruction or distortion of archeological data or disregard proper archeological field techniques.

Signature ____________________________________ Date __________________


Big Bend Archeological Society
P.O. Box 1
Big Bend National Park, TX 79834

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