To join EGS, print the following form, complete, and mail to the address indicated.

Date ________   Joining for what year _____ 

Check one: ___ individual membership ___ family membership

Mr/Ms/Miss/Mrs __________________________________________ __________
                Last        First       Initial            Maiden 

For Family:
Mr/Ms/Mrs    __________________________________________ ____________
              Last        First       Initial               Maiden 
Primary
Address: __________________________________________________
         
         __________________________________________________
                                                  zip+4
Secondary
Address: __________________________________________________
         
         __________________________________________________
                                                  zip+4
Dates at Primary ______________  Dates at Secondary _____________

Phone number   ________________________

E-mail address _________________________

List surnames researching on back.

Dues: $20 individual $35 family (living in same household)
        
Membership includes a complete set of EGS quarterly newsletters (one per family).

MEMBERSHIP YEAR: JANUARY 1 THROUGH DECEMBER 31 FOR EACH YEAR.
Persons may join EGS at any time during the year but all memberships end on December 31 of each year. Send this form with check payable to: Elgin Genealogical Society, Treasurer, PO Box 1418; Elgin, IL 60121-1418.

________________________________________________________________
OFFICE USE ONLY:
Date ______________ Ck. # ___________ Am't. ______________ ________________________________________________________________