Iowa City Genealogical Society Membership form for the calendar year 202__

Name(s)___________________________________        Date _ _ _ _/_ _ _ _/_ _ _ _ _ _

Address___________________________________        Phone________________________________

City___________________________           State__________________       Zip code______________

E-mail address________________________________________________________________________

(for electronic delivery of newsletter and meeting updates/ cancellation notices)

ANNUAL DUES _________  (Check type of membership)    Individual $10.00____    Family $13.00____

Print out this page and mail it with your check to:

Iowa City Genealogical Society
Attn.:  Membership

P.O. Box 822

Iowa City, IA 52244-0822