GSVB Membership Application
 

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     Name    ___________________________________________________________      
 

     Address ___________________________________________________________


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     Phone   ________________________  E-Mail __________________________  



   SURNAMES  If you wish, list the surnames you are researching:

         Family name          Date in History         States lived in 

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   New Membership  ( )         Renewal ( )  

   Individual Membership	$  25/year 
   Family		      	$  30/year 
   Life		 	      $ 250 (10 x Individual)
   Institutional		      $  25/year  

   Mail with check to:  Genealogy Society of Vallejo-Benicia 
                        734 Marin Street  
                        Vallejo, CA  94590-5913  

                   or bring it to the next meeting!