Membership Application - Clan Brown Society

Online Membership Application

Clan Brown - The Official Homepage of the Clan Brown Society,

Type of Membership:	Individual	$35.00+$15.00
	Family	$35.00+$25.00
	Associate	$35.00+$15.00
	LifeTime Over 55	$400.00
	LifeTime Under 55	$600.00
All prices are in US Funds

Name:		Birth Date:
Spouse:		Birth Date:
Address:
City:
State:
Zip Code:
Home Phone:
E-mail:

Office Phone:

E-mail:

Children under 18:
1.		Birth Date
2.		Birth Date
3.		Birth Date
4.		Birth Date

Signature:

_____________________________________________

Date:

May we use your name on any published list of members?

Yes

APPLICANTS FOR CLAN BROWN MEMBERSHIP:

Please show your line of descent, with place and date of birth, and place and date of death, if possible.

Your:Father/Mother:_________
Birth Date:
Death Date:
Place of Birth:
Place of Death:

Spouses:Father/Mother:
Birth Date:
Death Date:
Place of Birth:
Place of Death:
Your:Grandfather/Mother:
Birth Date:
Death Date:
Place of Birth:
Place of Death:
Spouses:Grandfather/Mother:
Birth Date:
Death Date:
Place of Birth:
Place of Death:
Browns:GGrandfather/Mother:
Birth Date:
Death Date:
Place of Birth:
Place of Death:

After you create an Ancestor Chart on the form we give you, please forward a copy to the Clan Genealogist
Hebert L. Fletcher,
50 Spring Street,
Wakefeild, MA, 01880
for the Clans genealogy files.

Check each of the following activities in which you would be willing to participate:

	Help man a clan tent at the games.
	Scottish music, and/or dance.
	Contribute articles to Newsletter.
	Contribute Scottish books to the library.
	Serve on a Society Committee
	Help with genealogy.
	Use my computer to help.

SPECIAL INTERSTS OR HOBBIES that might contribute to the Clan Brown Society:

After page is filled out, print and send with check or money order to ( Please make check or money order payable to Clan Brown Society )

Jaythomas J. Brown
Web Master
38 High Rock Street
Lynn,Massachusetts
01902-3815