Lincoln-Lancaster County Genealogical Society
PO Box 30055
Lincoln, NE 68503-0055
___New
___Renewal
Today's Date_________________
Name___________________________
Telephone (home)_______________
Address_________________________
Telephone (work) _______________
City_____________________________ State_____ Zip + 4_________
E-Mail Address__________________________________________________
DUES/DONATIONS MEMBERSHIPS ARE DUE SEPT 1. MEMBERSHIP YEAR IS SEPT 1–AUG 31
| ___
|
Individual 1-Year Membership
|
$ 15.00
|
| ___
|
Family 1-Year Membership
|
$ 20.00
|
| ___
|
Individual Patron
|
$ 25.00
|
| ___
|
Family Patron
|
$ 30.00
|
| ___
|
Friends of the National Archives Fund
|
$ ______
|
| ___
|
Total
|
$ ______
|
For Treasurer’s Use ____/____/____
Check No. _____________________
Cash Rec’d ____________________
Receipt No. ____________________
|
* Please make checks payable to LLCGS and mail to the address above.
Enclose a self-addressed, stamped envelope if membership cards are to be mailed.
Please help save volunteer time by printing clearly. Use additional paper if needed.
YOUR RESEARCH SURNAMES:
PLEASE LIST UP TO EIGHT (8) SURNAMES YOU ARE RESEARCHING:
________________, ________________, ________________, ________________,
________________, ________________, ________________, ________________
YOUR GEOGRAPHIC RESEARCH LOCATIONS
PLEASE LIST ANY USA STATES AND THEIR COUNTIES YOUR ARE RESEARCHING:
_______________________, _______________________, _________________________,
_______________________, _______________________, _________________________
PLEASE LIST ANY OTHER COUTRIES AND THEIR REGIONS, PROVINCES, STATES, CITIES,
TOWNS, OR VILLAGES YOU ARE RESEARCHING:
_______________________, _______________________, _________________________,
_______________________, _______________________, _________________________
Home