Aquarium of Niagara Membership Form
Complete the form below, and mail it with your payment to the Aquarium. Then sit back, we'll do the rest!
Please Print:
Name ________________________________________________________
Address ______________________________________________________
City _________________________________________________________
State ______________________ Zip ______________
Phone __________________________
Type of Membership (Please Check One):
Family ($50.00) ______ (Number of Children _______)
Grandparent ($45.00) ______ Single Adult ($35.00) ______
Adult Couple ($40.00) ______ Single Senior ($25.00) ______ Senior Couple ($35.00) ______
Sand Dollar ($100.00) _______ Sea Star ($225.00) ______
Please charge to:
____ VISA ____ MasterCard ____ Discover ____ American Express
Account Number _______________________________________
Expiration Date ________________________
Signature _____________________________________________
TOTAL AMOUNT ENCLOSED __________
Make checks payable to: Niagara Aquarium Foundation
Mail to:
Aquarium of Niagara - MEMBERSHIP
701 Whirlpool Street
Niagara Falls, NY 14301-1094