Clan Hamilton Society
LAST NAME __________________________ FIRST ___________________
MIDDLE ______________ Circle One: MR MRS MR & MRS MISS MS
ADDRESS _______________________________________________________________
CITY _______________________________ STATE __________ ZIP + 4 ___________________
COUNTRY ___________________ HOME PHONE (______) ______________________
E-MAIL ADDRESS ________________________________________
SPOUSE __________________________________
PREFERRED GREETING (ie Jim, Sue, Jim & Sue) _____________________________________________
CHILDREN AND THEIR BIRTH DATES_____________________________________________________
____________________________________________________________________________________
Please list the name or names that make you eligible for membership and/or
explain how you are descended from an ancestor of eligible name.
___________________________________________________________________________________
____________________________________________________________________________________
May we release this information to members and/or print in An Darach? YES NO
Please include a Genealogical Chart with the completed application for membership.
While this is not required, it is strongly encouraged and will help us help you with
future inquiries. Use as many charts as necessary or use the back of this page.
Please list names of others that may be interested in joining the Society.
Use back of page if necessary.
| Membership Type | US | Can | UK | AUS |
| Regular/Associate/Family | 20 | 20 | 10 | 20 |
| Junior | 6 | 6 | 3 | 6 |
| Life (age < 40) | 350 | 350 | 175 | 350 |
| Life (Age 40-49) | 300 | 300 | 150 | 300 |
| Life (age 50-59) | 250 | 250 | 125 | 250 |
| Life(age 60+) | 200 | 200 | 100 | 200 |
(Please circle one and remit correct amount in US funds with this application)
ALL CONTRIBUTION ABOVE THE STATED AMOUNT FOR MEMBERSHIP WILL BE GRACIOUSLY ACCEPTED TO HELP OFFSET COSTS OF HIGHLAND GAMES, NEWSLETTER, ETC.
Mail completed application with any attachments along with your check to:
Thomas
E Brock
Clan Hamilton Society
P.O. Box 670
Piney Flats, TN. 37686
FOR CLAN USE ONLY: MBR. # MBR. SINCE: |