Wapello County Genealogical Society Membership Form
Name: __________________________________
Address: ________________________________
City: ___________________ State: ________________ Zip: __________
Email Address: _________________________
Membership Type: (check one)
Individual___________$15.00
Family_____________$20.00
Life________________$125.00
Mail or deliver personally this form with your payment to the above address.
Are you researching Surnames? If so, you may list those names here.
_______________________________________________________________________
Would you like your name, address & email address published with the names you are researching listed in the newsletter? Yes__________ No_________
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