Please Print
Name(s):
___________________________________________________________________________________
Address:
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
Telephone Number: (____)______________ E-mail address________________________
New Member____ or Membership Renewal____
Type of Membership: (Check one)
___Individual ($17): ___Couple ($22): ___Senior Single: 62+ ($15): ___Senior Couple ($19)
___Lifetime (15 times annual membership)
Genealogy Special Interests:
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
Surnames you are researching:
___________________________________________________________________________________
___________________________________________________________________________________
___________________________________________________________________________________
Please mail this form with your check to:
Eastside Genealogical Society
P.O. Box 374
Bellevue, WA 98009-0374
Go to