Iowa County Genealogical Society

PO Box 321
Dodgeville, WI 53533-0321
MEMBERSHIP APPLICATION FORM
Name: ________________________________________________________________________

Address: ______________________________________________________________________

City: ___________________________________ State _____________ Zip: ________________

Phone # ______________________ Email ______________________________________

Iowa County Surnames you are researching:

1 ______________________________________4______________________________________

2 ______________________________________5 ______________________________________

3 ______________________________________6 ______________________________________

Membership Requested:

Individual $10.00 ______ Household $15.00 _ _____ Junior (High school age or younger) $5.00 _______ (**USA funds only)

**if paying by international money order from a NON-USA bank, please add and additional $5.00 (USA) to your membership price. This fee is collected by our bank for processing international bank requests.

Membership is for one year based on a calendar year of January 1 to December 31

Household memberships will receive just 1 copy of the Society mailings

Please include payment with the enclosed application form.
Please make checks payable to: Iowa County Genealogical Society or ICGS
and mail to the address at the top of this form.

Thank you for joining our Society. We look forward to working with you in the preservation of Iowa County records and history.

(revised 1-2006)


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