American French Genealogical Society
Membership Application
(Please print, complete, and mail this form along with your payment)

 

NAME:_____________________________________________ 

ADDRESS:__________________________________________ 

CITY:______________________________________________

STATE (PROVINCE):________________________________

ZIP (POSTAL CODE):________________________________

COUNTRY: ________________________________________

PHONE NO:________________________________________

INTERNET E-MAIL:_________________________________

If Family Membership Family Members NAME:_____________________

TYPE OF MEMBERSHIP 
Values in ( ) Are Rates Outside U.S.

box   Individual $ 35.00 US (Outside of US $45.00)
box   Family $ 35.00 + $10.00 each additional member
  Family (Outside of US $45.00) + $10.00 each additional member
box
  Institutional $40.00 US (Outside of USA $50.00)
box
   Life $600.00 US (Outside of USA $800.00)
Membership      box New box Renewal 
Member #________________
Make All Checks Payable To: AMERICAN-FRENCH GENEALOGICAL SOCIETY
Canadian Residents: Please Use Postal Money Orders, In U.S. Funds Only

Please allow 3-4 weeks for Processing We accept Visa and MasterCard!
Check One: boxVisa box MasterCard

CARD NUMBER:_____________________________________ 

NAME ON CARD:____________________________________ 

EXPIRATION DATE:_________________________________

SIGNATURE:________________________________________
 

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Please mail to:
-
American-French
Genealogical Society
P.O. Box 830
Woonsocket, RI
02895-0870
 
Updated July 14, 2013 Copyright 2000-2013 by American-French Genealogical Society, All Rights Reserved