Membership Application

Name______________________________________________________________
Address____________________________________________________________
City, State, Zip______________________________________________________
Phone_____________________________________________________________

E-mail Address______________________________________________________
I would like to receive monthly meeting notices by e-mail____, by postcard____ or not at all____.

New Membership________       Renewal Membership________

Membership Fees are: (Check Which One)

[ ]     15.00 Per Year membership, receives the "Eaton County Quest" published April,
         August and December.

[ ]     10.00 Per Year membership, does not receive the "Eaton County Quest."
 

I would like to help the society with a donation to:      
General fund ______   Other ________  for total amount of ______________.

Mail application to:
Eaton County Genealogical Society, Inc.
P.O. Box 337
Charlotte, MI 48813-0337

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For office use only:

Date rec'd_______________________________ Rec'd by________________________

Check Number______________________      Amount Paid _______________________

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