Printable Membership Form

Print this page by clicking on the printer icon on your menu bar or going to File then Print
Click Here to return to the last page.

Name (please include spouses maiden name when applicable):

Address:

City:

State

Zip

Email (optional):

Phone (include area code) (optional):

Ancestry (if known):

Name of earliest Goddard ancesteor:
Born When?	Born Where?
Died When?	Died Where?

Membership:

Individual:

Husband/Wife:

Family:

1 Yr $15 or 3 Yr $40

1 Yr $20 or 3 Yr $50

1 Yr $25 or 3 Yr $65

Comments:

Signature:

Please make check payable to GH&GS and mail to:
    GH&GS Membership Chairperson
    (Mrs.) Alice Godard Allen
    172 Oldefield Farms, Enfield, CT 06082

The Goddard Historical and Genealogical Society is a 501 (c)(3) not-for-profit organization.
Contributions are tax deductible under applicable IRS rules.