Membership Application Form

Membership Application Form

Membership Form
Hardin Co. Genealogy Society Box 520 Kenton, Ohio 43326

Membership renewal is on your aniversary date of membership.

Name:_________________________________________

Address:_______________________________________

Apartment:_____________________________________

City:_____________ State:

Zip Code:______________________________________

E-Mail Address:_________________________________

CHECK ALL THAT APPLY

Single Dues: $10.00 ( )
Married Couple Dues: $12.00 ( )
Student Dues: $5.00 ( )
Family Dues: $15.00 ( )
New Member ( )
Renewal ( )
OGS Member ( )

Make checks payable to
Hardin County Genealogy Society

Please list below the Hardin County surnames you are researching. They will be printed in the next newsletter.

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Please print out form fill out and return with check to:

The Hardin County Genealogy Society, Box 520, Kenton, Ohio 43326-0520

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