Name: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Street Address or P.O. Box: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

City: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

State: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Zip plus 4: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Phone: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

E-mail address: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Fax: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Use computer for genealogy purposes? . . . . . . . . . . . . . . . . . . . . .

Software used: . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . . .

Membership; New or Renewal. (Circle one)

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Membership

All current yearly memberships include four issues of The Middle Tennessee Journal of Genealogy & History. Dues are $25.00 per membership year if paid prior to the beginning of the fiscal year on June 1. If joining (or renewing) after this date, dues are $25.00 plus $5.00 for mailing of back issues of the Journal for the current membership year. Applications or renewals received after March 15 of the current fiscal year will be accepted for the next fiscal year beginning on June 1. Make check or money order payable to Middle Tennessee Genealogical Society (MTGS).