Membership

CGN – APPLICATION FOR MEMBERSHIP

Name:
__________________________________________________________
Address:
__________________________________________________________________
City:
_____________________
State:
_____________
Zip+4:
_____________
Home Phone:
_____________________
Work Phone:
_______________________________
Email Address:
_____________________
Email Event Reminders to you?
___Yes ___No
Voluntary Information…

Indicate your membership in similar
organizations
(genealogy, etc.)….

__________________________________________
__________________________________________
Can you help with publicity? …………………………………..
___Yes ___No

Details: _______________________________________________________________________

Facility for meeting available to you?……………………..
___Yes ___No

Details: _______________________________________________________________________

Nearby Cemeteries to you… (list) ……………………………
_________________________________________
_________________________________________
_________________________________________

On the reverse side of this form, let us know about your basic interests in gravestone studies or suggestions that might help to support our objectives.

It would help us organize programs throughout Connecticut if anyone having an association has to a facility that we could use for an occasional meeting or event with our grup. If you do, please let us know. We are also looking for co-sponsor support to promote our annual symposium efforts.

If there is a tour or other related activity that you could offer to help in our sharing efforts, please include a description.

____________________________________________________________________________

Annual Dues are $10.00

Please make your check payable to “CGN” and send it with this application to:

CGN c/o Ruth Shapleigh-Brown
135 Wells Street
Manchester, CT 06040 – 6127