Membership Application
Join Us...and help keep your heritage alive!

MEMBERSHIP APPLICATION

ROCKWOOD AREA HISTORICAL & GENEALOGICAL SOCIETY
P. O. Box 95
Rockwood, Pennsylvania 15557
Print this page, fill in the requested information, and mail along with payment to the address listed above

Please accept my application for membership in the Rockwood Area Historical & Genealogical Society

Name______________________________________________

Address____________________________________________

City____________________________ State__________ Zip Code__________

Phone_____________________ Email___________________________

Names I am researching______________________________________________________________________

Type of Membership (Please check one. Dues are payable annually)

______Family Membership - $25.00

______Individual Membership - $15.00

______Student Membership - $5.00

______Business/Organization Membership - $100.00

______Life Membership - $250.00

Amount Enclosed:____________ (Please make check payable to Rockwood Area Historical & Genealogical Society)

Signature___________________________________ Date_____________________

THANK YOU for your support!

 
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