Blue Hills Genealogical Society - Barron County Membership Application Form

Please print this form out, then fill it in and mail it along with your membership check to: BLUE HILLS GENEALOGICAL SOCIETY - BARRON COUNTY, INC.
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MEMBERSHIP APPLICATION
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Membership dues (within the USA) for one calendar year are $15.00 (single) or $22.50 (dual ).
Membership dues (non-USA) for one calendar year are $18.00 (single) or $27.00 (dual ).
Dues are payable in US funds only!
Our membership year runs from April 8th of one year until April 7th of the following year.
Please make checks payable to:    Blue Hills Genealogical Society - Barron County, Inc. or BHGS-BC, Inc.
Mail to: P.O. Box 383, Cameron, WI 54822 .
PLEASE PRINT ALL INFORMATION:
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NAME________________________________________________________DATE_________________________
                    First                       Middle                          Last
2nd NAME (FOR DUAL MEMBERSHIP __________________________________________________________
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ADDRESS___________________________________________________________________________________
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CITY______________________________COUNTY_____________________STATE______ZIP______________
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TELEPHONE NUMBER_______________________________________________________________________
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EMAIL ADDRESS____________________________________________________________________________

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