BIRMINGHAM GENEALOGICAL SOCIETY
Post Office Box 2432, Birmingham, AL 35201MEMBERSHIP DIRECTORY INFORMATION & MEMBERSHIP APPLICATION FORM
Name: ___________________________________________________________________ Telephone #: (_____) _________ - _________________Address: ______________________________________________ City: _______________________________ State: _______ Zip: ______________
E-Mail address: ___________________________________________________________________________________________________________
List any other genealogical groups you are a member of:____________________________________________________________________________
_______________________________________________________________________________________________________________________
ANCESTOR INFORMATION
Surname and Maiden Name Birth Date & Place Death Date & Place
1. Name: _____________________________________ ___________________________________ __________________________________
Maiden: _____________________________________ ___________________________________ __________________________________
2. Name: _____________________________________ ___________________________________ __________________________________
Maiden: _____________________________________ ___________________________________ __________________________________
3. Name: _____________________________________ ___________________________________ __________________________________
Maiden: _____________________________________ ___________________________________ __________________________________
4. Name: _____________________________________ ___________________________________ __________________________________
Maiden: _____________________________________ ___________________________________ __________________________________
5. Name: _____________________________________ ___________________________________ __________________________________
Maiden: _____________________________________ ___________________________________ __________________________________
6. Name: _____________________________________ ___________________________________ __________________________________
Maiden: _____________________________________ ___________________________________ __________________________________
7. Name: _____________________________________ ___________________________________ __________________________________
Maiden: _____________________________________ ___________________________________ __________________________________
Membership dues are $15.00 per calendar year, payable before January 1st of each year and may include an additional member of the family. One copy per family of the Society's quarterly magazine, PIONEER TRAILS, is included with your membership. MEMBERS MAY SUBMIT QUERIES TO "PIONEER TRAILS" FOR FREE (Limit 4 queries per family per quarterly). NON-MEMBERS may submit queries @ $5.00 per query, limited to 52 words per query, not including address. ********** FOR OFFICAL USE ONLY **********_____________________________________________ __________________ ___________________________________________________
Recommended by Date accepted Membership Chairperson