membership application

Membership Application

If you would like to join (or renew your membership in) The Downriver Genealogical Society, please fill out the Application below and mail with a check or money order in the amount of $15.00 (U.S. Funds) to: The Downriver Genealogical Society, P O Box 476, Lincoln Park, MI 48146
Membership Application (please print)   Date______________________

Name (Last First)_____________________________________________

Maiden Name ________________________________________________

Street _______________________________________________________

City _________________________________ State __________________

Zip ______________- _______ Phone (______)______-_______________

E Mail Address: ______________________________________________

Home Page __________________________________________________

Please check: New Membership [ ]    Renewal [ ] Membership # ____________

Surnames being researched: (please list four of The surnames you are researching)

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Date Pd _____________ Ck No _______________ Cash _____________