Moultrie County Historical & Genealogical Society
Membership Application
Membership includes three issues of Moultrie County Heritage and twelve newsletters.
| Regular Member | $20.00 |
| Sponsoring Member | $35.00 |
| Sustaining Member | $100.00 |
| Student Member | $5.00 |
Fill out form below and mail to MCH&GS.
| Name: | |
| Address: | |
| City: | |
| State: | |
| Zip: | |
| Type of Member: | |
| Amount Enclosed: |
Make check payable to MCH&GS.
Mail to MCH&GS,
P.O. Box 588, Sullivan, IL 61951