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Polk County Genealogical Society, Inc. Membership Application

Name:____________________________________________________________________________

Address:__________________________________________________________________________

City:_____________________________________________ State:___________________________

Zipcode:_______________________ Phone:_____________________________________________

Email:____________________________________________________________________________

Receive newsletter via email?_________Yes __________No

Type of membership: (please check one) INDIVIDUAL __________ FAMILY (2 votes) ___________

New member? (please check) _______ Add $5.00 to total amount 1 year ________ 3 years ________

TOTAL AMOUNT ENCLOSED: $________________________

Please make checks payable to: PCGS Inc. or Polk County Genealogical Society, Inc.
Mail to the following address: PCGS, PO Box 632, Bolivar, MO 65613-0632


Current members of PCGS, 1 year membership:
INDIVIDUAL MEMBERSHIP----------$20.00
FAMILY MEMBERSHIP (2 votes)-----$25.00

Current members of PCGS, 3 year membership:
INDIVIDUAL MEMBERSHIP----------$60.00
FAMILY MEMBERSHIP (2 votes)-----$75.00


New members joining January 1-October 15, 1 year membership:
INDIVIDUAL MEMBERSHIP-------$20.00 + $5.00 = $25.00
FAMILY MEMBERSHIP (2 votes)--$25.00 + $5.00 = $30.00

New members joining October 15-December 31, 1 year membership:
Pay full price for the next year and get 2 months' free membership in current year
INDIVIDUAL MEMBERSHIP-------$20.00 + $5.00 = $25.00
FAMILY MEMBERSHIP (2 votes)--$25.00 + $5.00 = $30.00


New members joining January 1-October 15, 3 year membership:
INDIVIDUAL MEMBERSHIP-------$60.00 + $5.00 = $65.00
FAMILY MEMBERSHIP (2 votes)--$75.00 + $5.00 = $80.00

New members joining October 15-December 31, 3 year membership:
Pay full price for the next year and get 2 months' free membership in current year
INDIVIDUAL MEMBERSHIP-------$60.00 + $5.00 = $65.00
FAMILY MEMBERSHIP (2 votes)--$75.00 + $5.00 = $80.00


Please contact PCGS at
info@pcgsmo.com for more information or with questions.

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