Minnesota Mineral Club New Member Application

Membership Type*

Note: Family Membership is limited to no more than two adults within one household and any minor children under their guardianship. We define household as living together at the same address.

Single - $24
Family - $36

Primary Member

Whether you've chosen a Single or Family Plan, please fill out the next four fields.

Primary Member*

First Last

Primary Member Email*

Primary Member Phone*

Address*

Street Address Address Line 2 City State ZIP Code

Family Plan Members Only

You chose Family Plan, please submit responses for the remaining fields. If you selected the Single Plan, please skip down to Special Interests

Second Adult Member*

Will your family membership include a second adult in your household?

Yes
No

Second Adult Member*

First Last

Second Adult Member Email*

Enter Email Confirm Email

Second Adult Member Phone*

Youth Members*

How about kids? Are there any minors in the household that you would like to include in your Family Membership?

Yes
No

How many youth members?*

Youth Member(s) Under 18*

For additional youth members, click the + icon located at after the last name field.

First Name	Last Name

Special Interests

All registrants must select a special interest(s).

How did you find out about us?

Special Interests

Select all that apply.

Special Interests - Other

CAPTCHA

Next Steps

Thank you for filling out the application. Select the orange SUBMIT button, and you will be asked to agree to membership terms with an online signature. Thereafter, you will confirm your membership level and pay the first year's fee.

Membership

First Step: Registration

Membership Application

Primary Member

Family Plan Members Only

Special Interests

Next Steps