Membership Application

 &

Renewal Form

Please print, complete & return to our mailing address →

BROAD RIVER GENEALOGICAL SOCIETY, INC.

PO Box 2261

Shelby NC 28151-2261

 

Please make check or money order payable to Broad River Genealogical Society, Inc. - Dues $25.00 per Calendar Year

 

Today's Date

$25.00 per Calendar Year

Name

 

Spouse’s Name

 

Mailing Address

 

City

 

State

 

Zip + 4

 

Phone  #

 

FAX #

 

E-mail

 

Website

 

Please check one

  I prefer a printed bulletin, please mail.                                                   Please send pdf file to e-mail address listed above. (We must have correct e-mail address.)

 

Could you include a photo of yourself?

May we have an ancestral chart?

May we eventually publish your ancestral chart?

Yes _____  No _____

 

Surnames of Interest

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

Query for publication. Free to members.

 

 

 

 

 

 

 

 

 

For Office Only

Date Rec’d

Check #

Amt

Posted/Membership Files