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Autauga
Genealogical
Society
P. O.
Box
680668
Prattville,
Alabama
36068-0668
Membership Application
Memberships dues are $20.00 per individual/couple. Please print this page and mail it along with your payment. Checks should be made payable to Autauga Genealogical Society.
Date
Submitted:_________________
Enclosed
is my
check
in
the
amount
of
$__________
Please
accept
my
application
for:
____New
Membership
____Renewal
____Query
____Change
of
Address
Included in the above amount is a $________ donation to Autauga Genealogical Society, Inc., a non-profit organization. Please insure that it goes toward promoting the cause of genealogy in Autauga County, Alabama.
[Mr.][Mrs.][Ms.]_______________________________________________________
Address: ____________________________________________________________
City:__________________________ State:____________ Zip:_________________
Phone: ( _____ ) _____________ E-mail: ___________________________________
I am researching the following surnames: _____________________________________
___________________________________________________________________
Query: _____________________________________________________________
___________________________________________________________________
___________________________________________________________________
___________________________________________________________________
___________________________________________________________________