Membership Application
Puerto Rican/Hispanic Genealogical Society, Inc.
P.O. Box 260118, Bellerose, NY 11426-0118

Name:
Address:    Apt/Box

City:      State: .  .  Zip: -

Telephone: ( ) - E-Mail Address: @

Personal Genealogy Web Site URL: http://
 
Publish Name, E-Mail Address on Online Membership  Listing ? :    

                                                                                     
List five (5) surnames currently being researched:(To be listed in PRHGS, Inc. web site)
Surname / Apellido
Town / Pueblo
District / Barrio
Start
End
Membership year runs from January to December. Memberships received prior to November 1st will receive all of the current year's newsletters, the Genealogy "tool-kit" and a copy of the current year's surname directory, Apellidos Familiares.  Memberships received after November 1 will be extended into the following year.  Members will receive their Genealogy "tool-kit", the November/December issue of the current year's newsletter, all of the following year's newsletters and will receive the following year's edition of the surname directory. 
Individual 
$20.00 		A money order (in U.S. dollars) should be made out to 
Puerto Rican / Hispanic Genealogical Society, Inc.

 
SIGNATURE:_________________________________________ DATE:_________________ 
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Please fillout and print this form and mail it to with your membership fee to the address indicated above.
Allow 6 - 8 weeks for delivery.