Carolinas Genealogical Society 
Membership Application
Name: ____________________________________________________________________________
Address: ______________________________________________________________________________________
City: ____________________________________________
State: ______________________Zip code: ______________
Phone: (_____) ____________________________________
[ ] Individual Membership: $18.00
[ ] Family Membership: $20.00
Mail to:
Carolinas Genealogical Society
Post Office Box 397
Monroe, North Carolina 28111
Family names, Counties and States being researched:
( you may submit up to 25 surnames)
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Page change date: September 2003