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____.

2012 New Membership________                   2012 Renewal Membership________

Dues are accepted for one calendar year only.  Any additional funds will be considered a donation.

Membership Fees  (check which one you prefer)

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

[ ]     15.00 Per Year membership receives no publication
 

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

Check Number______________________      Amount Paid _______________________

Date received  ______________________       Received by _______________________

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