Form

             The Great Southern Family History Society

                                  Katanning Shire Library

                                  Austral Tce, Katanning WA.6317

           Mailing Address = 8 Cliff Street, Katanning, W.A. 6317 

           Email - Address = d.irene@westnet.com.au

                           ANNUAL SUBSCRIPTION 2013/2014

       SINGLE MEMBERSHIP- $20.00              JOINT MEMBERSHIP -$30.00    

 

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GIVEN NAME/S                                                                                                                 .                                                                                                                

ADDRESS                                                            TOWN                                                                                                                                                                                                   

STATE                POSTCODE                 TEL                                      FAX                                            .                                                     

EMAIL                                                                 .

I/We apply for membership for the year ending 30^th April 2014

SIGNATURE/S

DATE;

PLEASE LIST THE SURNAMES THAT YOU ARE RESEARCHING

 

 

Surname	Place/Town	State/County	Country	Period