Belmont County Chapter OGS Membership Application

Membership Application
for Belmont County Chapter, OGS

Fill in and Print the form. Send completed form with check or money order for membership dues to the address below.

Name:

Address:

State:

Zip: (You must your include the

4 digit extension to zip code. Lookup your Zip + 4 here.)

Email Address (optional):

Surnames that you are searching:

Your Belmont County query:

Your query will appear in The Gateway to the West newsletter

Membership Option

New Renew

Single $10.00

Joint $12.00

Family Membership $14.00

A gift of in honor/memory
of

Make check or money order (credit cards not accepted) payable to:
Belmont County Chapter, OGS

Membership Card: Please include First Class Stamp with your application.

Current OGS Member: No Yes Number:

Please note: If you are an OGS member please enter your OGS membership number. OGS requires that we have a certain number of chapter members that are also OGS members and this is the only way to keep track.

Mail to:  Belmont County Chapter, OGS
          P. O. Box 285 
          Barnesville, OH  43713

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