WHSM

Last updated April 19, 2007

Membership Form

Yearly membership (Includes six newsletters) $10.00 _____ Renewal $10.00 _______

Name____________________________________________________________________________

Street____________________________________ City/State/Zip____________________________

Telephone No.____________________________ Email__________________________________

Surnames researching _____________________________________________________________

________________________________________________________________________________

Make check or money order payable to the Waushara County History & Genealogical Society and mail to
P.0. Box 616, Wautoma, WI 54982.