MEMBERSHIP APPLICATIONMembership Year is January 1 - Dec 31
To receive a Membership Card - PLEASE INCLUDE AN SASE (SELF-ADDRESSED, STAMPED ENVELOPE).
Enclose check and mail to:Decatur Genealogical Society P O BOX 1548 Decatur IL 62525-1548
Please TYPE or PRINT Legibly
Name _________________________________________Phone ____________________
Family Memberships may list a second member ___________________________________
Additional family members, 18 years or younger may be added for $5.00 per person.
Mailing Address: __________________________________________________________
City___________________________State ______________ Zip+4 _________________
E-Mail Address: _______________________________________
Winter (or other address) ____________________________________________________
City __________________________State ______________ Zip+4 __________________
Date alternate address to start? _____________ Date to end? __________________
MOVING???? Publications will NOT
be returned to DGS with an address correction.
Replacement quarterlies will be sent, if requested, at a charge of $3.00 per issue plus $1.25 postage.
EIGHT (8) SURNAMES OF INTEREST - PLEASE PRINT LEGIBLY IN ALPHABETICAL ORDER
New members (Surnames of Interest) will be listed in the first quarterly published after their membership has been received.
(Out of U.S. please write for cost)
*Memberships mailed after April 1st - add $3.00 for mailing of back Qtly's & Newsletters
PLEASE CHECK APPROPRIATE LINE BELOW
Individuals, libraries or societies||$15.00||____|
Family Membership(2 adults-same household)||$20.00||____|
Additional Memberships for family members age 18 or younger|| $5.00||____|
Individual Life Membership||$300.00||____|
Family Life Membership(2 adults-same household)||$500.00||