HOME

redline

Longmont Genealogical Society Membership Application

(Please print this page to use for your membership application)

redline

Date ____________________________

Name _______________________________________________________________________

Maiden Name (if applicable)____________________________________________________

Second Family Member (if applicable)____________________________________________

Birthday Month_______________________Day of the Month__________

Street ________________________________________________________

City/Town _____________________________________________________

State__________________________Zip+4___________________________

Telephone: (__________) _________________________________________

E-mail:________________________________________________________

____  Individual membership ($15.00)

____  Family membership ($18.00)

Mail to:

Longmont Genealogical Society

P.O. Box 6081

Longmont, CO 80501-2077

redline

HOME