MEMBERSHIP RENEWAL

ST. BERNARD GENEALOGICAL SOCIETY, INC.

P O Box 5748
Slidell LA 70469-5748

___________________________INDIVIDUAL MEMBERSHIP $25.00

 

___________________________FAMILY (HUSBAND & WIFE) $25.00

DUES ARE PER CALENDAR YEAR (JANUARY - DECEMBER)

I am enclosing my payment in the amount of $25.00 for
membership for the year 2005.

(PLEASE PRINT OR TYPE)

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NAME

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ADDRESS

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CITY STATE ZIP + 4

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TELEPHONE                                                            

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E-MAIL ADDRESS                                                               

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VISIT US ON THE INTERNET http://www.ccugpc.org/sbgs/sbgs.htm

(Please complete, print and send to address as provided above)