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Columbiana County Chapter of O.G.S.
PO Box 861
Salem OH 44460
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MEMBERSHIP APPLICATION
YOUR MEMBERSHIP IN THE COLUMBIANA COUNTY CHAPTER OF THE OHIO GENEALOGICAL SOCIETY
SUPPORTS THE COLLECTION AND PRESERVATION OF FAMILY AND LOCAL HISTORIES.

NAME: ____________________________________________________

ADDRESS:________________________________________________________

CITY: ____________________________________ STATE: ______________

9-DIGIT ZIP: _________ + _____
Plus 4 required for bulk mailers
E-MAIL Address: _____________________________________
If you reside at another address at any time during the year include
that address and the months of stay at that address.

NAME:___________________________________________________________
ADDRESS:____________________________________________________________
CITY: ________________________________________ STATE: _____
9-DIGIT ZIP: __________ + _____
( Plus 4 required for bulk mailers )
MONTHS AT THIS ADDRESS: _______________________________
Is this MEMBERSHIP: NEW _____ or RENEWAL: _____

Membership is $15.00 a year includes The Connection Newsleter
Enclosed is my check made payable to "THE COLUMBIANA COUNTY CHAPTER OF O.G.S"
in the amount of . . . . . . . . $____________

COLUMBIANA COUNTY SURNAMES: _________________________________________

COLUMBIANA COUNTY QUERY: Please print or type, include names, dates if known,
and the information sought.

___________________________________________________________________________

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