WASHINGTON STATE GENEALOGICAL SOCIETY
APPLICATION FOR MEMBERSHIP
(including Reinstatement and Renewal)

 Name: ____________________________________________________________________________________

 Maiden Surname: _________________________________ Spouse's Name: ______________________________

 Address: __________________________________________________________________________________

 City: _______________________________________ State: ___________ Zip+4: ________________________

 Telephone: (_______) _______________________            E-mail: ______________________________________

 Indicate here if you do not wish to have your information published in our membership directory
        Address ___________       Phone Number _________       Email Address ____________


Single Membership           $12.00 per year         (Membership year is from Jan 1 to Dec 31)

Family                              $13.00 per year         (Receives only one copy of periodicals)

Society                             $12.00 per year

New Membership _____    Renewal _____    Reinstatement _____

Please enclose a S.A.S.E. if you would like a membership card mailed.



Send this form and check
(payable to WSGS) to:
 		WA State Genealogical Society
P.O. Box 1422
Olympia, WA 98507-1422