HOWGS Membership Form

Detach and mail with a check for $15 payable to:

Heart O' Wisconsin Genealogical Society

P.O. Box 1565
Wisconsin Rapids, WI 54495-1565

Name: ______________________________________________________________________________

Address: ____________________________________________________________________________

City: _____________________________________  State: _______________  Zip Code: ____________

Phone: ( ____ ) _________________________  Email: ________________________________________

Circle one:       New Membership       Renewal Membership _______________________________________________________