Membership form

THE FRANKLIN COUNTY
GENEALOGICAL & HISTORICAL SOCIETY
FOUNDED 1970
A Chapter of the Ohio Genealogical Society

To become a member of The Franklin County Genealogical & Historical Society:
1. Print out this simple form
2. Mail it and your check to:
The Franklin County Genealogical & Historical Society
3378 Park Street, Suite D
Grove City, Ohio 43123-2630

MEMBER:

Last Name:___________________________First Name:_________________Inital:____

Maiden Name:__________________________ Phone:___________________

Address:_________________________________________________________________

City:______________________________ State:____________ Zip:_________________

Ohio County Required:_______________________________________________________

E-Mail:______________________________ Are you an OGS Member?___________

Associate Member (if desired): (Associates must accompany a Primary / Patron membership and live at the same address)

Last Name:____________________________First Name:_________________Inital:_____

PLEASE CHECK MEMBERSHIP: ____ NEW____ RENEWAL
________Primary @ $ 15.00
________Patron @ $ 50.00
________Associate #_________x $3.00
________Corporate @ $ 1000.00
________Life @ $ 300.00
________Joint Life @ $ 500.00

________Total Payment Enclosed