Northwest Georgia Historical
& Genealogical Society
Membership Application


Membership in the Northwest Georgia Historical and Genealogical Society is open to anyone who shares the goal of preserving the history of Northwest Georgia and it's families. Membership and subscription information can be found on the Membership Application below. Print the application, and return to the Society via U.S. Mail.

Dues

Membership dues are $15.00 per year. A subscription to the Quarterly is included in this charge. Four issues are published each year. Note: Single issues of the Quarterly may be ordered at $5.00 per issue.
Yes, I want to join. Enclosed is a check for the appropriate dues made payable to the Northwest Georgia Historical and Genealogical Society, Inc.
(1 year - $15), (2 years - $30), (3 years - $45) 
Name:__________________________________________________________
       (Last)                          (First)                          (Middle or Maiden)

Street Address:_________________________________________________

City:________________________State:______________Zip:___________

Occupation:_____________________________________________________

Phone #:_________________    FAX: ________________________________

E-mail address:______________________________

Surnames you are Researching (Include locations and time period of research):
____________________________________________________________________________________________

____________________________________________________________________________________________

____________________________________________________________________________________________

____________________________________________________________________________________________

Genealogical References in Your Personal Collection That You Would Be Willing to Consult for Others:

____________________________________________________________________________________________

____________________________________________________________________________________________

Do you have a Personal Computer?  If so, would you be willing to help with typing for the Society?___________
Skills & Talents (Typing, Library Skills, Writing, Publishing, Abstracting and Recording, Photography, Art, etc: 
____________________________________________________________________________________________
Are you willing to help with scanning past quarterlies into the computer? ________________________________
Suggestions for Society Projects:________________________________________________________________
____________________________________________________________________________________________

Please return this form with your membership dues of $15 per year to:
Northwest Georgia Historical and Genealogical Society
Post Office Box 5063, Rome, Georgia 30162-5063

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