APPLICATION FOR MEMBERSHIP

HODGEMEN COUNTY GENEALOGICAL SOCIETY

October 1 through September 30

SURNAME___________________________________________________ GIVEN NAME ___________________________________________
 

MAIDEN NAME___________________________________________ HUSBAND'S GIVEN NAME __________________________________

MAILING ADDRESS ___________________________________________________________________________________________________

STREET ADDRESS (if different from mailing address)_________________________________________________________________________

CITY _____________________________________________ STATE ________________________ ZIP CODE+FOUR_____________________

TELEPHONE  (_____) ___________________________ E-MAIL ________________________________________________________________

HODGEMAN COUNTY NAMES YOU ARE RESEARCHING __________________________________________________________________

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Dues are $7.50 annually. Please make checks payable to HCGS and submit with application to Hodgeman County Genealogical Society, P. O. Box 608, Jetmore, KS 67854-0608.