MEMBERSHIP APPLICATION OR RENEWAL FORM

[return this complete page with dues including address label (member number(s) is on label)]

For renewals if there is NO change from information on address label you do not have to complete the rest of this form, only * items if there are changes to information you have previously submitted.

Please place an “X” by changes in any area of your membership status.

May information be used in a membership directory (if published) or placed on the web site. __ Yes __ No

NAME ______________________________ Mbr. No. ____ *SPOUSE ________________Mbr. No.____

                                                                                                Maiden name ____________________

*ADDRESS ___________________________________ email *________________________________

*CITY _________________________________ *STATE _________ *ZIP __________________ (5+4)

____  New Member ____  Renewal          Dues are $12 per household for 12 months, January-December

Make check payable to: Union County Chapter OGS

► Are you a member of Ohio Genealogical Society Yes ____ No ____

Surnames you are researching in Union County: _____________________________________________

____________________________________________________________________________________

Monies earned from the sale of publications are used to purchase research books and materials for Marysville, Plain City, and Richwood Public Libraries. Donations are used to purchase microfilm for the Marysville Public Library. We are a 501(c)(3) society.

Return form and dues to:           Union County Chapter OGS

                                                PO Box 438

                                                Marysville OH 43040-0438