ROSEVILLE GENEALOGICAL SOCIETY 
              MEMBERSHIP APPLICATION/RENEWAL FORM
                        P.O. Box 459
                     Roseville, CA 95678



Instructions: please print and fill out this form, and mail 
it with your annual dues, to P.O. Box 459, Roseville, CA 95678. 
Please make out your check to RGS. Questions may be directed to 
Helen Astill at hastill@surewest.net. 

__________$15.00 Single

__________$20.00 Couple.

Print Name___________________________________________________________

Address______________________________________________________________

City_________________________________________________________________

Zip Code_____________________________________________________________

Telephone (      )___________________________________________________

E-Mail Address_______________________________________________________

I would like to continue to receive my Newsletter by Mail 

       Yes________ No_________

I would like to receive my Newsletter Online Yes________ No________

          Thank You, the Roseville Genealogical Society