CENTRAL CALIFORNIA CHAPTER-AHSGR
3233 North West
Fresno, CA  93705-3402
559-229-8287

Member/Renewal Application for 2014

 

Name: ______________________________________ Village: _____________________________________

Maiden Name ________________________________  Birth Date ___________________________________

Spouse's Name _______________________________  Village ______________________________________           

Maiden Name ________________________________  Birth Date ____________________________________

Anniversary __________________________________

Address __________________________________________________________________________________       

City _____________________________ State ______________________ Zip __________________________       

E-mail Address _______________________________________________ Phone ________________________   

Deliver Newsletters by mail Yes ___ No ___

Youth/Student Name ___________________________________________  Birth Date _____________________

Youth/Student Parents Names ___________________________________________________________________

Name of Person paying for Youth/Student membership _________________________________________________

Surnames you are researching

__________________________________________________________________________________________    

OFFICE USE ONLY   Date Paid ______________ Amt Paid __________  Years(s) Paid for __________________

Renewal _____ New _____ Category F  R  Y  S

Yearly Chapter Dues $15_____  Youth $8_____ Student $15_____ *National Dues Pd $_______   

Local and National dues are to be sent to the Local Chapter

PR___ Cpr___ DuesRem ___ NLML___ SML___ Allmail___ CpEM___ EMlist___ BD___

New Mem Pkt_____ Comp :lists_____ CaCDC report _____

PLEASE NOTE: Dues are due by January 1 and delinquent

 


                                        National Membership Fees: Please check the one you are requesting.

_____ $35 Basic Membership.  All Member benefits, voting rights.  Open access
to SOAR, and receives convention invitations, special notices and annual appeals
except NO Journals, Newsletters, or Clues.

_____ $50 Standard Membership.  All Member benefits, voting rights.  Open access
to SOAR, and receives convention invitations, special notices and annual appeals
except including Journals and Newsletters except NO Clues.   

_____ $100 Premium Membership.  All Member benefits, voting rights.  Open access
to SOAR, and Members only SOAR and receives convention invitations, special notices
 and annual appeals including Journals, Newsletter and Clues.

______ Life Membership Year of Birth ________________

 

Payments: Please call the Membership Chair regarding the sliding scale for yearly payments.

If making a payment or requesting a Life Membership please note the amount ____________________

_____ Ages 26-40 is $1,050

_____ Ages 41-55 is $900

_____ Ages 56 and older is $750

All member benefits, voting rights, open access and Members only SOAR and receives convention invitations,
special notices and annual appeals including Journals, Newsletters and Clues.

 

*****NOTE: If you sent your National Membership to National Headquarters in
Lincoln, Nebraska just write that on the fron so it is noted in your records..