LCIGS: Membership Application

Lake County (IL) Genealogical Society
P.O. Box 998
Mundelein, IL 60060-0998

MEMBERSHIP APPLICATION

Membership Year: July 1 - June 30

Quarterlies: Fall / Winter / Spring / Summer **

R F L S _______

Members may renew
for a maximum of 5 years
at current rates:

1) check the appropriate membership line for dues,
2) check whether a new member or a renewal
3) write the starting year & for how many years in the appropriate blank,
4) multiply the amount checked by the number of years, add donation amount, if applicable and
5) write in the Total Amount Due

LCIGS is a 501.c.3 Organization. Your voluntary donation may be tax deductible according to the current law. If you wish to make a donation, please note it here: Donation: $__________
Members can pre-pay for a maximum of 5 years at current prices. *Please note that prepaid dues are not refundable!* ** Begin my membership on 01 July 20_____ for ____ years
Dues:	____$25 Regular/Library ____$27 Family (same address) ____$30 Foreign ____$10 Student (Full-time student under age 22)	____New Member ____Renewal	Total Amount Due: $______________

Make check payable to:
Lake County (IL) Genealogical Society

Mail check & this form to:
Lake County (IL) Genealogical Society
P.O. Box 998
Mundelein, IL 60060-0998

***Please enclose a self-addressed stamped envelope for the mailing of your membership card.***
Name(s):
Street:
City:	State:	ZIP+4:
Telephone:	May we publish the phone number? ___Y ___N
Email:	May we publish the email address? ___Y ___N

Would you be willing to help our society by volunteering for one of our projects?______________

List four new names each year for the surname directory.
We accept a maximum of 4 names per regular membership or 8 names per family membership.
(Please put Names 5-8 on the reverse side of this application.)

Surname Given Names Locality Time Period

1.
1.
1.
1.

2.
2.
2.
2.

3.
3.
3.
3.

4.
4.
4.
4.

**First Quarterly of the membership year is mailed in the fall; the Summer Quarterly contains the directory of submitted surnames

Form 07/2008