Membership Application

Name:________________________________________________
Address:______________________________________________
City:_____________State:______Zip:_________Country:_____
Phone:________________________________________________
E-Mail:_______________________________________________

Additional Family Members

Name                                                                      Relationship
________________________________      ____________________________
________________________________      ____________________________
________________________________      ____________________________
________________________________      ____________________________
________________________________      ____________________________

Areas of interest

qART                                                    qHIGHLAND GAMES
qDANCE                                              qHISTORY
qGAELIC                                              qLITERATURE
qGENEOLOGY                                    qMUSIC
qPIPES                                                  qNEWSLETTER

qADMINISTRATION                        qCLERICAL
qOTHER:______________________________________________________

GENEOLOGY

FATHER  ______________________ MOTHER ________________________
FA FA      ______________________  MA MA  ________________________
FA MA    ______________________  MA FA  ________________________

Membership includes a quarterly newsletter and any other future benefits that the Clan Drummond Society agrees upon.  Membership also is needed to be an officer in the Clan Drummond Society.

Fees:
Individual membership is $20.00 a year or 4 issues of the newsletter
Family Membership is $20 plus $2 per extra person in same residence.  This will also be for one year or 4 issues of the newsletter

All prices are in US Currency

Send To:

Clan Drummond Society
c/o William Drummond
1031-D Nursery Rd.
Chipley, FL 32428
USA