Membership Application

The work of the Society is never done and requires continued interest and constant attention.  We invite anyone who shares our interests and goals to become a member and join us in preserving and promoting the heritage of our community.  

NAMES _____________________________________________________________

MAILING ADDRESS ___________________________________________________

CITY _____________________________ STATE ________ ZIP ________________

PHONE NUMBER (____)_______EMAIL ADDRESS _________________________

Date: ______________  How did you hear about us?__________________


Type Of Membership


No. of Persons

Annual Member

$15 each


Child Member (Birth up to 18 years)

$5 each


Family Member (husband/wife/children under 18)

$30 / family


Life Member

$200 each



I would like to make a donation to the Society of $____________.

I might be interested in helping with an activity, please contact me ___________.

Please print application and send check and application to:

Geneva Historical and Genealogical Society, Inc.
Membership Chairman
PO Box 91
Geneva, Florida 32732

Reg. # SC-11193 - FL Solicitation of Contributions 

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