Westchester County Genealogical Society
Incorporated 1991 / Founded 1982
P. O. Box 518
White Plains, New York, 10603-0518
NAME:    __________________________________________________________________

ADDRESS: __________________________________________________________________

CITY:    ____________________________ STATE: ____________ ZIP: ____________

PHONE:   (____) _____________________ CELL PHONE: (_____) _________________

EMAIL ADDRESS: ____________________________________________________________
PUBLISH IN MEMBER LIST:
Address: ___ Yes ___ No Phone: ___ Yes ___ No Email: ___ Yes ___ No
HOW DO YOU WANT TO RECEIVE THE MONTHLY NEWSLETTER?
EMAIL ONLY: ______ REGULAR MAIL(Surcharge will be applied): ______

Please provide us with the following information:
Countries of genealogical interest: _______________________________________
___________________________________________________________________________

U. S. states of genealogical interest: ____________________________________
___________________________________________________________________________

Topics of genealogical interest: __________________________________________
___________________________________________________________________________

Field trips of interest: __________________________________________________
___________________________________________________________________________
Field trips most convenient:
___ Weekdays ___ Saturdays ___ Sunday
Other genealogical society membership(s): ________________________________
___________________________________________________________________________
List five (5) surnames currently being researched: (To be published in WCGS newsletter.)
___________________________________________________________________________
Check () committee(s) of interest:
___ Programs ___ Publicity
___ Hospitality
___ Seminar ___ Membership ___ Finance
___ Newsletter ___ Indexing ___ Trips

Check () annual membership(s) of interest: (Payable in U.S. dollars)
___ General $25 ___ Surcharge $10 (for newsletter by postal mail) ___ Student $10 (under 21 years) ___ Institutional $30
SIGNATURE: ________________________________________ DATE:__________________
Membership Application & Information Sheet

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