CGS MEMBERSHIP APPLICATION and RENEWAL FORM |
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| PLEASE PRINT LEGIBLY: | ||
| NAME: | DATE: | |
| ADDRESS: | ||
| CITY: | STATE: | ZIPCODE+4: |
| COUNTRY: | HOME PHONE: | |
| E-MAIL ADDRESS (mandatory for foreign memberships): | ||
| SURNAMES BEING RESEARCHED (maximum 6) each spelling variation counts as one name: | ||
| Choose one: ______New Membership ______Renewal | ||
Choose one type of membership (multiple-year memberships are not available at this time): |
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| ______$ 20 Individual, Library, Society. One-Year Membership (begins July 1, 2008 and expires June 30, 2009) | ||
| ______$ 30 Contributing. One-year Membership (begins July 1, 2008 and expires June 30, 2009) | ||
| ______$250 Life Membership | ||
| Additional monies (check all that apply): | ||
| ______$10.00 (ALL countries outside the U.S., including Canada, MUST add this amount for P&H) | ||
| ______$1.00 suggested as a contribution to NARA (National Archives Fund) | ||
| Make check payable in U.S. funds to: CHICAGO GENEALOGICAL SOCIETY | ||
| Mail with this form to: Chicago Genealogical Society, P.O. Box 1160, Chicago, IL 60690-1160 | ||
| Please send separate checks for Membership, Pioneer and Rebuilder Certificates, Publications, and other services. | ||
FOR OFFICE USE ONLY |
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| Date Received | Membership # |
| Amount Received | Expiration Date |
| Check # | Entered Date |
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This page was updated 28 October 2008.
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