Memberships
begin January 1 and end December 31 of each calendar year. Back issues
are mailed to those who join after the spring issue is mailed. If you are
applying in the fall, you may want your membership to begin next year. Please
indicate if you want membership for this year or next year.
APPLICATION FOR MEMBERSHIP, PAGE 2
(If Renewal) Membership #
______ NEW: Begin this year |_| Begin next year |_|
Name ________________________________ Date _____________________
Address ________________________________________________________
City _________________________________State _ Zip _________________
Phone (__________) - ________ - ________________
(If not U.S.A.) Country _______________________________
E-Mail Address: ___________________________________________________
Please indicate all your desires:
|__|
INDIVIDUAL MEMBERSHIP (includes Subscription to TERRELL TRAILS)
Per
Year $20.00 $ _____________
|__| FOREIGN
Per Year $25.00 $ _____________
|__|
DONATION TO SPECIAL ARCHIVE FUND:
Used to locate, store, and distribute information about TERRELLS and their
descendants.
Please help us continue to provide information
for you. (Please circle amount)
$1,000 $500
$100 $50 $25
OTHER $ _________________
CHECK #
_____________________________ MONEY ORDER # _______________________
DATE:
____________ TOTAL ENCLOSED $ __________________
Signature:
________________________________________________________________
Enclose check or money order; mail to:
Terrell
Society of America, Inc
128 20th Ave NW
Cairo GA 39827-1017
