Genealogical Society of Central Missouri

GSCM Membership Application:

If you would like to become a member of GSCM, please print this form, complete the following
information and send to:

GSCM Membership
P.O. Box 26
Columbia, MO 65205-0026

Date: __________________________________________
Last Name: _____________________________________
First Name: ____________________________________
Street: ________________________________________
City: __________________________________________
County: ________________________________________
State/Province: ________________________________
Zip Code (9-digit): ____________________________

Home phone: ________________________________
Work phone: ________________________________
Fax number: ________________________________
E-mail address: ____________________________

Library Volunteer: Yes/No
Past Workshop Attendee: Yes/No

Surnames you are researching:
__________________________________________
__________________________________________
__________________________________________

Include the contact information above in GSCM directory?: Yes/No

Membership year is Jan. 1 through Dec. 31. Application is for calendar year _____.
Membership rates are (circle one):
$15.00 for individual or for family membership

_____ new member _______ renewal

Submission of a four generation pedigree chart requested with membership application.