Membership Registration Form
Member Information:
First Name:   Required
Last Name:   Required
Family Member First Name:   (Only if "Family" Membership)
Family Member Last Name:   (Only if "Family" Membership)
Address:   Required
Address 2:  
City:   Required
State / Province:   Required
Postal Code:   Required
Phone:   Required, Formatted as (000) 000-0000
Cell Phone:   Formatted as (000) 000-0000
Email:   Required
Membership Options:
Registration Type: New
Please make a selection.

Membership Type: Individual ($22)
Family ($27)
Lifetime ($400)
Please make a selection.

Donation Options:
I would also like to make a donation to the Virginia Room. Please add
$ to my dues to cover this donation.
I would also like to make a donation to Stern NARA. Please add
$ to my dues to cover this donation.
The FxGS is a volunteer society. Please consider becoming part of this wonderful group of dedicated individuals. For each category below, please enter the committees, activities, or talents you would like to contribute.
Programs, Conferences, Newsletter, Marketing, Records, Projects, Education, Membership
Set up/clean up (meetings, classes), Help with fall fair, Help with annual spring conference, Proofread/help edit newsletter, Help prepare surname list. Distribute flyers, Write a newsletter article, Help with mailings, Make phone calls, Lead a field trip, Teach a class, Staff FxGS booth at events, Lead or assist with a project, Transcribe, Assist with quality project reviews, Lead a special interest group, Develop procedures manual
Special Skills or Interests::
Grant Writing, Legal Advice, Records Retention, Trusts and bequeaths, Other
Surname Exchange List:
Please provide a list of Surnames Being Researched with County and State or Country and time period:

Human Validation:
Check this box:   and enter code