Please print and mail to:
Fairfield County Chapter OGS
503 Lenwood Drive
Lancaster, OH 43130-2261 

Today’s Date __________________

Name _________________________________________________________________________

Address _______________________________________________________________________

City ______________________________  State __________  Zip_______________-_________

Phone (for Chapter use only, not for publication) ____________________________________________

Email _________________________________________________________________________

______ Check here to receive your newsletter electronically by E-mail (our preference) 

______ Check here to receive your newsletter by US Mail

_____ Single ($15.00)             _____ Joint ($18.00)     

_____ Donation included          $_________________  Thank you!

______Yes, My Name, Address, Email & Surnames may be published in Upcoming Chapter Directories.

______No, please do not include my Name, etc. in any upcoming Chapter Directories.

 Are you currently a member of the Ohio Genealogical Society?                  _____Yes        _____No

Surnames being researched:

________________________________                    ___________________________________

________________________________                    ___________________________________

________________________________                    ___________________________________

________________________________                    ____________________________________

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   For Office Use