Cuyuna Rock, Gem & Mineral Society

Membership Form

Instructions: Membership includes family members living in the same household, including children under the age of 18. Dues are $20 per year per household.

Membership Application PDF

Please download, print, complete and send to:

Cuyuna Rock, Gem, and Mineral Society
1001 Kingwood St., Ste. B-40
Brainerd MN 56401

Or Fill This Electronic Form

NOTE TO RENEWING MEMBER

Important, Please Note:

If you are a renewing member, please remember to use a DIFFERENT EMAIL ADDRESS. Thank You!

First & Last Name *Name on credit card

Names of other Household members(must be 18 or under - comma separated)

Email *

Phone

Street Address *

City

State

ZIP / Postal Code

Number of Memberships

One membership includes family members living in the same household, including children under 18.

Membership StatusNew MembershipRenewal Membership

Currency

USD

Choose one of the options below.Credit CardMail In

Mail In

Please make checks payable to: Cuyuna Rock, Gem, & Mineral Society

Send to:
Cuyuna Rock, Gem & Mineral Society
1001 Kingwood St.
Suite B-140
Brainerd, MN 56401

Credit / Debit Card *

Register