Alachua County Genealogical Society
Application for Membership
Post Office Box 12078 - Gainesville, FL 32604 
I hereby apply for membership in the Alachua County Genealogical Society and pledge my loyal support to the good of the Society and to its members.  I understand that my membership shall be effective for the calendar year in which my application is approved, that I will receive copies of the Quarterly  issued during said year and that annual dues are payable on or before January 1st of each year.
Type of Membership:
(____) Individual
(____) Family
Annual Dues:
$18.00
$20.00
PLEASE PRINT OR TYPE ALL INFORMATION
Mr/Mrs./Miss/Ms ________________________________________________ Birthdate _________________ 

Mailing Address _______________________________________ Home Phone __________________ 

City/State/ZipCode ___________________________________________ Business Phone _____________________

Occupation/Profession _____________________________________________ (_____) Active  or   (____) Retired

Year started researching ______  If Professional Genealogist, please state your specialty: _______________________

Available for speaking engagements?  Y/N (_____)  Topics:_____________________________________________

Current membership in Genealogical/Historical organizations:
NGS (____)  --  FLGS (____)  --   DAR/SAR (____) --   ACHS (____)     Other____________________________
LIST INITIALS & SURNAMES, DATES and 3 STATES YOU ARE RESEARCHING
(please list all surnames in alphabetical order)
ex: A. SMITH/1820-50/NC>GA>FL . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .... 
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TREASURER - Date:____________
PRESIDENT --- Date:____________
SURNAME ---- Date:____________
SECRETARY-- Date:____________
LIBRARY ------ Date:____________
.___________________________________________________
Signature of Applicant                                   Date
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