Please print out and mail to JGSLI. Make check payable to the JGSLI at:

37 Westcliff Drive ................................................... Dix Hills, NY 11746

Date_____________________

Name(s)_______________________________________________

Address________________________________________________

City____________________________State________Zip Code_____________

Phones: [day]____________________[evening]__________________

[fax] ________________ e-mail address________________________

(Membership is for one calendar year, January to December)

____Individual ($25)

____Family ($30)

____Contributing ($36)

____Lifetime ($250 / Individual – $300 / Family)

____Out of Town* ($15) (* Outside Nassau, Suffolk and Queens Counties.)

Please use an additional sheet to list the surnames and corresponding towns you are researching. Also, please list any special interests or skills you have.

For more membership information e-mail our VP Membership at membership@jgsli.org