Central Oklahoma Chapter AHSGR (Membership Form)
(Members are encouraged to join National AHSGR to help preserve our history for future generations)
Chapter membership dues are based on the calendar year. Dues are $15 per person or $20 per couple.
Name(s):__________________________________________________________________________
Address:__________________________________________________________________________
Telephone: Home: _______________________________
Cell: _________________________________
E-mail: ______________________________________
Renewal _________ New Member _____ Individual________ Couple__________
Dues for year: 2023, 2024, 2025 (Please circle one) $ Total Amount Paid: ______________
Person 1: Family Surnames;______________________________________________________________
Ancestral Villages;____________________________________________________________________
Person 2: Family Surnames;_____________________________________________________________
Ancestral Villages;____________________________________________________________________
Are you currently a member of AHSGR? Yes___NO___ Do you plan to join AHSGR? Yes___No__
Please make checks payable to "Central Oklahoma Chapter AHSGR"
Send dues to: Paulette Schroeder, 14031 Crossing Way West, Edmond, OK 73013