Anderson County Chapter, SCGS
Membership Application

Date: _______________________________

Last Name: _____________________________________
 
First Name: _____________________________________  
   
Middle Name: ___________________________________ 




Maiden Name: ________________________________________
         
Address: ____________________________________________________________________


City: ______________________________ State: ______________ Zip: __________
  
Home Phone: __________________________Work Phone: ___________________________     Cell Phone_________________
      
Fax Phone: __________________________________ Email: _______________________________
   
Circle One: New Member Renewal 
 
Available Memberships - Circle One
INDIVIDUAL - $15.00 - Membership for one person.

FAMILY - $20.00 - Membership for 2 persons, same household.
 Name of 2nd person__________________________________________

ASSOCIATE - $10.00 - I am a primary member of another SCGS Chapter.
SCGS Chapter___________________________________ SCGS#___________

 
Please list below the names of those you are researching in this area. Please include full names, dates, and areas in Anderson County. Use the back of this form if you need more room to add surnames.
 

Surname, Given

Locations

Dates

  
    
Make check payable to ACC, SCGS.





Mail to: Anderson County Chapter, SCGS - PO Box 74 - Anderson, SC 29622-0074

Thank you for joining the Anderson County Chapter, SCGS.