Wapello County Genealogical Society Membership Form

Name: __________________________________

Address: ________________________________

City: ___________________ State: ________________ Zip: __________

Email Address: _________________________

Membership Type: (check one)
Individual___________$15.00
Family_____________$20.00 (same household)

Mail or deliver personally this form with your payment to the above address.

Are you researching Surnames in Wapello County? If so, you may list those names here.
_______________________________________________________________________

Would you like your name, address & email address published with the names you are researching listed in the newsletter? Yes__________ No_________