Membership Application Form

Fairfield County Genealogy Society

2023 Membership Application

(After November 15th, counted toward next year’s membership)
(Membership year is January-December, sorry non-renewals dropped from membership and newsletter mailing list after January 31st )

First & Last Name

Home or Cell No.

(if questions)

Address
City & State
Zip

(Need a contact address for mailing newsletter or correspondence.)

Memberships

$20 Membership / Year - Emailed Newsletter

$25 Membership / Year - U.S. Mailed Newsletter

$25 Membership / Year - Both Emailed & U.S. Mailed Newsletter

$25 Family (Same Home) Membership / Year - Emailed Newsletter (may include spouse/partner's name)

$25 Family (Same Home) Membership / Year - U.S. Mailed Newsletter (may include spouse/partner's name)

$25 Family (Same Home) Membership / Year - Both Emailed & U.S. Mailed Newsletter (may include spouse/partner's name)

$50 Patron Membership / Year - Emailed Newsletter (Designate a "Name in Honor or Memory of") (may include spouse/partner's name)

$50 Patron Membership / Year - U.S. Mailed Newsletter (Designate a "Name in Honor or Memory of") (may include spouse/partner's name)

$50 Patron Membership / Year - Both Emailed & U.S. Mailed Newsletter (Designate a "Name in Honor or Memory of") (may include spouse/partner's name)

$100 Benefactor Membership / Year - Emailed Newsletter (Designate a "Name in Honor and/or Memory of") (may include spouse/partner's name)

$100 Benefactor Membership / Year - U.S. Mailed Newsletter (Designate a "Name in Honor and/or Memory of") (may include spouse/partner's name)

$100 Benefactor Membership / Year - Both Emailed & U.S. Mailed Newsletter (Designate a "Name in Honor and/or Memory of") (may include spouse/partner's name)

$300 Lifetime Membership - Emailed Newsletter (Designate a "Name in Honor and/or Memory of" every year) (may include spouse/partner's name)

$300 Lifetime Membership - U.S. Mailed Newsletter (Designate a "Name in Honor and/or Memory of" every year) (may include spouse/partner's name)

$300 Lifetime Membership - Both Emailed & U.S. Mailed Newsletter (Designate a "Name in Honor and/or Memory of" every year) (may include spouse/partner's name)

Dues Payment

Membership is processed when dues payment is received.

Online

Mail Check

In Honor of and/or
Memory of
Designation

(for Patron, Benefactor or Lifetime Members)

Surname List

(List your Family Surnames you are researching.)

Research Query

(If you would like to submit a research request along with your membership form, please enter it here.)

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