Membership Form

Lycoming County Genealogical Society
P.O. Box 3625, Williamsport, PA 17701
E-mail: LCGSgen@aol.com
Home page: http://members.aol.com/LCGSgen/lcgs.htm

* Bimonthly newsletters containing local records, articles, and queries
* Meetings with instructional speakers (monthly ex. June, July, Aug)
* Access to the LCGS Library
Dues:
Individual - $15. per year Family - $20 per year.
Dues cover the calendar year from January 1 through December 31. Anyone joining after January will receive newsletters back to January upon request. If joining after October 1, dues will be considered paid for the following year.

NAME: ____________________________________________________
ADDRESS: _________________________________________________
CITY: ______________________________ STATE: ________ ZIP : ________- ______
TELEPHONE: _____________________________
E-MAIL: _________________________________

Surnames being researched:

________________________________________________________________________________________________________________________

Please enter my membership:
( ) individual $15 ( ) family $20
( ) 1 year
( ) 2 years
( ) yes, I want back issues of newsletter

Amount enclosed (payable to LCGS) $ _____________

For your privacy
( ) Permission to use previously submitted information from our data base (Surnames, email address, etc) when there is no information on the form

( ) Use only what is on this form

( ) No information in the newsletter