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Membership Application for Zero Point Forum

For

 Members of the Academic and Scientific Communities

Quantrek is a 501(c)3 and a 509(a) tax exempt publically supported non-profit organization. We will confirm your membership status via email.

Zero Point Forum membership amount and levels:

         Amount / Level

To become a member of the Zero point Forum, please complete the following membership form and pay online or fill out this application and mail it and your check to:

Dr. Edgar Mitchell

Quantrek, Inc

PO Box 540037

Lake Worth, FL 33454-0037

 

Your online membership payment is secured by:
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I am interested in making a restricted gift to the Frontier Science Endowment Fund. Please contact me or send additional information.

I would like to make an unrestricted gift to support the work of Quantrek. (Enter the amount you wish to pledge below).

Please send me an invoice for the amount I have pledged to contribute

 Amount pledged:     

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Thank you for your membership.