___________Individual $12.00                 ____________Student $7.00 ____________Family $15.00  ____________ Contributing Member $25.00(please check one)

Surnames you are searching:

_________________________________________________________________________________________________________________________

____________________________________________________________________________________________________________________________

I would be willing to help with the following projects:
_______Cemetery copying            ________Indexing
_______Computer entry               ________Newspaper indexing

Other____________________________________________________________________________________

I would like to see the following projects completed:

________________________________________________________________________________________

I do____ do not____ give my permission to have my information printed in any handouts, newsltters, or publications.

Please send copies of your pedigree charts for future publications.