New Individual Member Account

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Member Information

Member Name *

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Last

Birth 5 D.O.B

Phone *

Email *

Address *

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Date of Birth *

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Number of Freshwater Tanks

How many Freshwater Aquariums do you currently have and/or maintain?

Please list special interests if any

Share your special interests with us. Example, fish breeding, keeping seahorses, planted tanks, etc.

Number of Saltwater Tanks

How many Marine Aquariums do you currently have and/or maintain?

How did you find out about The Brooklyn Aquarium Society?

Please tell us how you first heard of us.

Waiver and Term Selection

Liability Waiver *

• I release The Brooklyn Aquarium Society and its board members of all and any liability and responsibility.

Select Membership Term - 1 to 5 Years [Click To Select]Individual Member - 1 Year - $20.00Individual Member - 2 Years [10% OFF] - $36.00Individual Member - 3 Years [15% OFF] - $51.00Individual Member - 4 Years [20% OFF] - $68.00Individual Member - 5 Years [25% !!! OFF] - $75.00

Select membership terms longer than 1 year for additional discount.

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