Membership Application

Lone Pine Gem & Mineral Society

PO Box 977
Lone Pine CA 93545
Name(s) ____________________________________________________________________
Address ____________________________________________________________________
Phone # Home ____________________________Work ______________________________
eMail Address: _______________________________________________________________
Membership dues are due January of each year and paid per person.
Dues schedule:

Children - free through 8 year

Student - 9 years through 18 years

Adult - 19 years and up

Adult (s) $20.00 x ____ = $________ student (s) $10.00 x _____ = $_______
The Lone Pine Gem & Mineral Society was chartered in April of 1997. We have grown from 6 members to
80 members. We were formed to develop and share our mutual interests in earth sciences. Our meetings
are the first Monday of the month in the Lions Club Building at 6:30 pm. We have at least one fieldtrip per
month. Our club lapidary shop is open the second Monday of the month. The shop opens at 6:30 pm and
lapidary instruction is available. The shop is also available at any time to club members that have
demonstrated basic usage and safety proficiency of the lapidary machines.
Comments: ___________________________________________________________________
_____________________________________________________________________________
Signed ____________________________________________ Date _____________________