Walsall Family History Group

Application for membership

Please print this form and return it to the secretary

I enclose the fee of £10 for 12 months membership.

Please make cheques/bankers drafts payable to the Walsall Family History Group

Name (Print) (Mr.Mrs.Ms.Miss).... __________________________________  
Address ............................................ __________________________________  
  __________________________________  
  __________________________________  
  __________________________________  
  __________________________________  
Post Code ......................................... __________________________________  
E-mail ............................................... __________________________________  
Tel. No ............................................. __________________________________  
Signature .......................................... __________________________________  
Date .................................................. __________________________________  

Details of Interests
(continue on separate sheet if necessary)

Surname Period Town County (Pre 1974)
       
       
       
       
       
       
       
       
Please delete the appropriate words below to indicate if you do or do not want your interests put on to the web site
I do/ I do not/ want my interests put on to the web site  
   
P.S. Could you tell us where you heard about our group : - _______________________________________________________________________
   
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