Membership Form

Please print and mail to:

Fairfield County Chapter OGS

503 Lenwood Dr.

Lancaster, OH 43130-2261
 
                                                                                       

 

 

 

 

 

Member since (year) ________    (We’re updating our records. If this is a renewal, please include year or ca. year.
If your dues are already paid for 2010, please return this form so that you will be included in the Chapter Directory.
Thank you!)

                                                                                                                

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Phone (for Chapter use only, not for publication) __________________________________________________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 an upcoming Chapter Directory.

 

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

 

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

 

_____ Donation included         Designated for: _____________________________________  Thank you!

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

 

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

 

Surnames being researched:

 

1. _________________________________                          2. _________________________________

 

3. _________________________________                          4. _________________________________

 

5. _________________________________                          6. _________________________________

 

7. _________________________________                          8. _________________________________

 

___________________________________________________________________________________

   for office use