membership application for SCGS

Membership Roster/ Surname Index Application
To print this application click the "print" icon on your browser Please complete the following application in full. This information is vital when publishing the Membership Roster/ Surname index. We do not keep the applications from year to year. Unless you return this application with your remittance, your surnames cannot be placed in the roster. Life members are also required to submit surnames each year for publication. Thank you for your cooperation!

Date_________________

Membership year begins January 1 New member_______ Renewal_________

DUES (please circle one) Individual $ 15.00          Life Membership - Individual $200.00
                                         Family     $ 17.00                                          Family      $300.00
                                         Foreign    $ 20.00
                                         Student    $ 3.00

Members Name______________________________Maiden Name_____________________

Street address__________________________________________City__________________

State____________________Zip code________-_________

Phone Number_(_____)________________E-Mail___________________________

The Above may be published in our directory yes______ no_____

Member of the Ohio Genealogical Society yes_______ no_____

Seneca County Surnames being researched______________________________________
_______________________________________________________________________
_______________________________________________________________________
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If you want a membership card, you must include a SASE.
Please make all checks payable to:   Seneca County Genealogical Society
                                                       P.O. Box 157
                                                       Tiffin, Ohio 44883-0157

Questions regarding your application? email us!