____ Corporate or Institutional Member-$1,500 per year
. . . . . .Allows three (3) memberships and participation of two corporate representatives in ShipREX activities.

____ Associate Members-$365.00 ($1.00 a day)

____ Individual Members-$36.50 ($.10 a day)

Make check payable to: ShipREX International, Inc. and mail to:
. . . . . . . . . . . . . . . . . . . .P.O.Box 781231, Sebastian, FL 32978

OR

Credit Card (please circle one) MC Visa Amex
Account # _____________________________
Name on Card ____________________ Exp. date ________
Credit Card Billing Address: _________________________________________________

Member or Corporation Name (s): ______________________________________________

_______________________________ . . . . . . . .__________________________________

_______________________________ . . . . . . . .__________________________________

Address: __________________________________________________________________

City: ______________________________ State: __________ Zip: ____________________

Country: ______________________ Phone: ______________ Fax: ____________________

E-mail: ____________________________ Website: ________________________________

Past Shipwreck Expedition Involvement or Interests (optional): __________________________

__________________________________________________________________________