Wabash County Genealogical Society
                 PO Box 825 Wabash, IN 46992

                      Membership  Form


Enclosed please find my check or money order in the amount of
$15.00 for membership year July 20_ _ through June 20_ _

Name ___________________________________________________

Address ________________________________________________

City _______________________________State ____ Zip ________

Phone (_____) _______________

Email __________________________________


Wabash County Surnames I am researching.

1. ______________________________   2. ____________________________

3. ______________________________   4. ____________________________