Membership Form

Please print and mail to:

Fairfield County Chapter OGS

503 Lenwood Dr.

Lancaster, OH 43130-2261
 
                                                                                       

 

 

 

 

 

Membersince (year) ________    (We’re updating our records. If this is a renewal,please include year or ca. year.
If your dues are already paid for 2011, pleasereturn this form so that you will be included in the Chapter Directory.
Thankyou!)

                                                                                                                

Name_______________________________________________________________________________

 

Address_____________________________________________________________________________

 

City____________________________________  State__________  Zip_______________-_________

 

County (if Ohio) _______________________________________________________________________

 

Phone (for Chapter use only, not for publication)__________________________________________________

 

Email   ______________________________________________________________________________

 

_____ Yes, my Name, Address, Email & Surnames may be published in anupcoming Chapter Directory.

 

_____ No, please do not include my Name, etc. in an upcoming ChapterDirectory.

 

_____ Single ( $14.00 )           _____  Family ( $16.00 )         

 

_____ Donation included         Designatedfor: _____________________________________ Thank you!

                                                         (Donationsthat are not designated will go to the Chapter’s Building Fund.)

 

* Are you currently a member ofthe Ohio Genealogical Society?                _____Yes        _____No

 

Surnames being researched:

 

1._________________________________                          2._________________________________

 

3._________________________________                          4._________________________________

 

5. _________________________________                          6._________________________________

 

7._________________________________                          8._________________________________

 

___________________________________________________________________________________

   for office use