Your name(s) in full, to be printed in the membership roll:

Date of Application:

Name and address to which mail will be addressed:

Name:
Address:
               
City:   
State/Prov.: Zip/Postal Code:
Country:
E-mail Address:
Telephone:

 

I/We apply for membership in the Society and enclose payment in the amount of
$ to cover the following category (check one):
Annual Membership $60.00
Joint Annual Membership $90.00
Life Membership (individual) $1,500
Joint Life Membership $2,250

The New York Genealogical and Biographical Society is designated a tax-exempt organization under Sec. 501(c)(3) of the Internal Revenue Code. The Society considers membership dues to be tax-deductible, except for the first $25.

Additional Contribution:
I/We would like to make an additional contribution in the amount of
$ to cover the following category (check one):
Friend (up to $500)
Contributor ($500 to $1,000)
Donor ($1,000 to $10,000)

 

Method of Payment:
Check or Money Order VISA Mastercard

Name exactly as it appears on credit card:
Card Number:
Expiration Date:

Make checks payable to The NYG&B Society. Payment from outside the U.S. must be in U.S. Dollars, either by credit card, by a check drawn on a bank with an office in the U.S., or by an international money order.