American French Genealogical Society
Membership Application

(Please print, complete, and mail this form along with your payment)
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NAME:_____________________________________________ 

ADDRESS:__________________________________________ 

CITY:______________________________________________

STATE (PROVINCE):________________________________

ZIP (POSTAL CODE):________________________________

COUNTRY: ________________________________________

PHONE NO:________________________________________

INTERNET E-MAIL:_________________________________

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

box   Individual $ 32.00 US ($40.00)
box   Family $ 32.00 + $10.00 each additional member
  Family ($40.00) + $10.00 each additional member
box
Institutional $27.00 US ($30.00)
box    Life $384.00 US ($480.00)
 
Membership      box New box Renewal 
Member #________________
box Please send me the Lending Library Kit - $3.00 (refundable on first order)
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 also accept Visa and MasterCard!
Check One: boxVisa box MasterCard

CARD NUMBER:_____________________________________ 

NAME ON CARD:____________________________________ 

EXPIRATION DATE:_________________________________

SIGNATURE:________________________________________
 

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Please mail to:
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American-French
Genealogical Society
P.O. Box 830
Woonsocket, RI
02895-0870
 
 
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Updated 24 July 2002

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