Taylor County Application

THE TAYLOR COUNTY HISTORICAL-GENEALOGICAL SOCIETY, INC
P.O. Box 1925
Butler, GA 31006

Application for Membership

Type:   (  ) Individual	$20.00/year
	(  ) Family	$25.00/year
        (  ) Sponsor    $50.00
        (Name listed in each issue as Sponsor)

NAME:_______________________

        ( ) Memorial Donation   $100.00 (Tax deductible)

Memorial to:_________________________________________

_________ Donations to Beechwood project (Gen John B. Gordon)

_________ Donations to support projects of TCHGS

_________ Research Donations  listed in one issue of Tracer


Name:________________________________________________________

Address:______________________________________________________

City: _____________________  State:____________  Zip Code:_________

Home Telephone:_______________  
E-Mail Address:
Website Address:


Family Membership is limited to two adults and dependent children living in the same household.  Only one copy of the NEWSLETTER will be mailed to family membership households.  Please submit separate applications for both family members and indicate your relationship.

Dues payable by January of each year.

Check attached  $______

Date received:  _______

Membership No.  _______

			Signature of Applicant__________________________