Membership Application

People joining as a couple should both fill out the membership form. Thank you.

Name: *

First

Last

Address: *

Location *

First

Middle

Last

Phone Number: *

E-Mail: *

Is this membership a renewal?

• Yes
• No

Membership plan choice

• Individual $12.00
• Couple $17.00
• Patron $25.00

How are you paying?

• Online Credit/Debit
• Mailed Check

Check No. if paying by check

Are you a member of the Ohio Genealogical Society?

• Yes
• No

Are you a member of the First Families of Ohio?

• Yes
• No

Are you a member of First Families of Lake County?

• Yes
• No

I would like a membership card. (Please send a SASE to Lake County Genealogical Society, c/o Morley Library, 184 Phelps St., Painesville, Ohio 44077-3927)

• Yes.
• No

I would like the LAKElines newsletter mailed (Only available to members without email)

• Yes

Each year in April, a Member's Roster is emailed to all members and posted on a password protected page on our website.

• I do not want to be included in the Member's only roster.

Date

Submit