Dekalb County Historical and Genealogical Society
Membership Form
Instructions:  Print this page.  Mail completed form and your payment to

DeKalb Co. Historical & Genealogical Society
Post Office Box 295
Sycamore, IL. 60178
 

Membership Form

 New _____     Renew _____                                                                       I would like the following membership:

  Date ___________________________________________           (          ) Household/Family Membership $15         

  Name(s) ________________________________________            (          ) Contributing Membership $25                          

  Address ________________________________________            (          ) Organization/Group Membership $15           

  City ____________________ State _____  Zip _________              (          ) Lifetime Membership $200                    

  Phone   (                ) _______________________________                           

  E-mail _________________________________________                   Amount Enclosed                  $__________

 I would Consider: 
    Officer:  Yes _____  No ______

    Committee type: ________________________________

 


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