CHAPTER MEMBERSHIP FORM - SOUTHEASTERN WISCONSIN CHAPTER / AHSGR 

All local members must hold membership. This membership in the International AHSGR entitles one to the AHSGR Journal with quarterly reports, genealogical and translation services at reduced cost and access to the AHSGR library and discount on library purchases. 

Name:___________________________________________________________

Address: _________________________________________________________

Birth Date: _______________________ ________________________________ 

Telephone No. ___________________ 

Ancestral Village(s) 

His: __________________________________________________ 

Hers: _________________________________________________

New Member: International Dues:......$50.00 Chapter Dues:.............$7.00 PER PERSON; $10.00 PER FAMILY
Renewals: International Dues........$50.00 Chapter Dues:..............$7.00 PER PERSON; $10.00 PER FAMILY
Late Fee: $2.00 (Late Fee after January 31) Make check to: AHSGR Southeastern Wisconsin Chapter Send check to:

Jan Harris
1527 Green Valley Road
Grafton, WI 53024-1006