MEMBERSHIP APPLICATION
Name____________________________Maiden Name_____________________________
Street_______________________________________County________________________
City_________________________________State_________________Zip_____________
Occupation________________________________Phone___________________________
Membership Classification_______________________Amount Enclosed________________ Searching for Surnames______________________________________________________Please make check payable to: Kishwaukee Genealogists, P.O. Box 5503, Rockford, IL 61125-0503
Dues for membership in Kishwaukee Genealogists:
Individual Membership- $10.00
Family Membership at the same residence- $12.00
Contributing Membership (Firms and Organizations)- S15.00
Life Membership- $100.00
Student Membership (18 or under)- $5.00