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South Mississippi Genealogical & Historical Society

P.O. Box 15271
Hattiesburg, Mississippi  39404-5271

(Please Print and send to above address: background image will not print)

Membership Form

Current membership rates are $15.00 per year for one member, or $20.00 per year for two members in the same household. To join, please print out this form and mail it with your check to the address listed above.

Name:
Address:
City: State: Zip:
E-Mail Address:

[      ]          Single Membership                                   $   15.00

[      ]          Double Membership                                  $   20.00

Surnames:
:
:

Copyright 1999
For problems or questions regarding this web contact [Email].
Last updated: 29 May 2006