Polish Genealogical Society of Texas
MEMBERSHIP APPLICATION

Annual Dues are $20.00 per calendar year.   Dues received after November 1 will apply to the
following year.   Print this form then mail application and dues to:

PGST,   P.O. Box 432,   Montgomery, TX   77356

 
Name:________________________________________________________________
              First                                          Middle                                              Last
Spouse:_______________________________________________________________
              First                                          Middle or Maiden                               Last
Address:______________________________________________________________
                   Number                                 Street
               ______________________________________________________________
                    City                                     State                                                 Zip
Phone: (       ) _________________ List phone number on membership list:   Yes   No   (circle)
 
Email Address: ________________________________________________________
 
Web Site: ______________________________________________ Listed on PGST Site
 
PGST SURNAME INDEX
Polish Family Name
(include variations) 		Village or Area of Poland
(from which family originated) 		Town, County, and Year
(where family settled)
     
     
     
     
     
     
     
     

Membership in PGST is participatory and reciprocal. Please volunteer your services and assist chairmen in the following: telephone committee, refreshments, membership, programs, surname index, sales inventory, articles for the periodical, mailouts, or render assistance to the editor.

Where did you hear about PGST? ________________________________________________________