Type of Membership Annual Dues Lifetime Dues
Regular Individual $15.00 $125.00
Student $ 6.00 $125.00
Senior Citizen
(age 50 & over)
$10.00 $125.00
Organizations and Sponsors Donations  

Annual dues are payable by January 31 of each year.
_____ Yes, I want to become a member of the Multicultural Genealogical Center.
Name __________________________(Please Print)
Address _____________________________________
Phone ________________________________________
email _________________________________________
Enclosed are my year 2006 dues for (check one):
__ Annual Regular Individual membership ($15.00)
__ Annual Student membership ($6.00)
__ Annual Senior Citizen membership--age 50 and over ($10.00)
__ Organization or Sponsor membership (donation of __________)
Or, enclosed are:
__ My lifetime membership dues ($125.00)
__ First installment, lifetime membership dues ($31.25)
__ Second installment, lifetime membership dues ($31.25)--due May, 2006
__ Third installment, lifetime membership dues ($31.25)--due August, 2006
__ Last installment, lifetime membership dues ($31.25)--due November, 2006
Family names I want to research are:
____________________
I also will support the MGC by:
__ Volunteering to work in the Research Center
__ Donating copies of my family tree/family history data
__ Donating copies of my family pictures, videotapes, etc.
__ Donating artifacts, etc. for exhibit ( __ temporary loan; __ permanent loan)
__ Sharing stories (oral history) about my family's lives in Southern Ohio
__ Working on a committee to compile pertinent data from records of
courthouses and other public sources
__ Sharing my experiences in gathering family history
__ Conducting short training session(s) on how to gather family history
__ Other ways (specify)_______________________
__________________________________________________
Contact me at (phone or email)_________________________
On (days of the week)_______________________________
At (hours) _________________________________________    (rev.3-02-06)
---------------------------------For more information contact:
Ada Woodson Adams, President, 740 448-1305   email amadams@frognet.net
Mrs. Debbie Rowe, Membership Chairperson, 740 551-2699 drowe@frognet.net
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Return this Application to:
The Multicultural Genealogical Center
P.O. Box 125
Chesterhill, Ohio 43728

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