Membership Roster/ Surname Index Application
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Please complete the following application in full. This information is vital when publishing the Membership Roster/ Surname index.  We do not keep the applications from year to year.  Unless you return this application with your remittance, your surnames cannot be placed in the roster.  Life members are also required to submit surnames each year for publication.  Thank you for your cooperation!

Membership year begins January 1                            New member_______   Renewal_________

DUES (please circle one)  Individual $ 15.00          Life Membership - Individual  $200.00
                                           Family     $ 17.00                                             Family      $300.00
                                           Foreign    $ 20.00
                                           Student    $  3.00

Members Name______________________________Maiden Name_____________________

Street address__________________________________________City__________________

State____________________Zip code________-_________

Phone Number_(_____)________________E-Mail___________________________

Member of the Ohio Genealogical Society   yes_______ no_____

Seneca County Surnames being researched______________________________________

Unless you indicate otherwise, the information above and the surnames you are researching may
be published in our annual directory.

Please make all checks payable to:  

Seneca County Genealogical Society
P.O. Box 157
Tiffin, Ohio 44883-0157

Questions regarding your application? Email us!

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