FELLOWSHIP OF BRETHREN GENEALOGISTS

MEMBERSHIP APPLICATION / RENEWAL

Name : ____________________________________________ Date : ________________

Address : _________________________________________________________________

City : ____________________________________ State : _____ Zip : _______________

E-mail Address : ___________________________________ Phone : _________________

Denominational Affiliation (optional): ____________________________________________

Direct Ancestor surnames with known Brethren Roots: ______________________________

________________________________________________________________________

Other Direct Ancestor surnames being researched: _________________________________

________________________________________________________________________

(List surnames alphabetically. Please attach a separate list, if necessary.)

Membership amount enclosed $ _______ ($12.00 per year for electronic subscription to journal or

$24.00 per year for paper subscription to Brethren Roots)

____ Renewal (due January 1)

____ New

Make check payable to:

mail to:

FELLOWSHIP OF BRETHREN GENEALOGISTS

Billi Janet Burkey

7980 Hebron Ave NE

Louisville OH  44641-9722