SEELEY GENEALOGICAL SOCIETY
1105 North Buckeye
Abilene, KS 67410-0337

You may print out this page from your browser,
or copy and paste the membership application into any word processor.
Mail your application to the above address.

Annual Membership Dues:
$10 per year, $18 two years, $25 three years or $36 five years. Lifetime memberships are $125. (Dues are in U.S. dollars and the membership year runs from Sept. 1 to Aug. 31)

Please include your dues with your application to speed processing.

	MEMBERSHIP  APPLICATION

NAME: ___________________________________________________
              (MR. - MRS. - MS - MISS - DR. [Circle one])
ADDRESS:  _______________________________________________

CITY:   _________________________________________________

STATE:  __________________  COUNTRY:  ___________________

ZIPCODE+4:  _____________________________________________

YOUR COUNTY:  ___________________________________________

PHONE:  _________________________________________________

E-MAIL:  ________________________________________________

WEB PAGE:  ______________________________________________

REFERRING MEMBER NAME & NUMBER (if applicable):  ________

_________________________________________________________

     May we print your phone number
      for the benefit of other members?
	Yes ___ No ___

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