Wabash County Genealogical Society
                 PO Box 825 Wabash, IN 46992

                      Membership  Form


Enclosed please find my check or money order in the amount of
$15.00 for my membership for year July, 20_____ - June, 20_____

Name ___________________________________________________

Address ________________________________________________

City _______________________________State ____ Zip ________

Phone (_____) _______________

Email __________________________________