TO: |
Douglas L. Edgmon
Membership Chairman
P.O. Box 905
Waldport, OR, 97394
Email: dledgmon@peak.org
|
APPLICATION FOR MEMBERSHIP
(Please Print)
Name of Applicant: | ________________________________________ |
| (Claiborne Descendant) |
Spouse: _______________________________
 
Mailing Address: | ___________________________________________________ |
| ___________________________________________________ |
| ___________________________________________________ |
Tel: _________________________
Fax: _________________________
E-Mail: _______________________
Name of Descendants (if known) __________________________________
Please include a pedigree Chart if you have one. Include at least 4 generations
Are you interested in sharing genealogical knowledge: yes _____ no _____
Signature __________________________________
 
Amount Due: Application fee ($20) plus
First year dues ($10) = $30 ____ or Lifetime Membership option of $200 _____
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