ANNUAL PCAHS MEMBERSHIP APPLICATION

Regular Annual membership rate is $20.00 and Lifetime membership
rate is a one time fee of $100.00 Please make check or money order
payable to PCAHS and mail along with the following information to:

PCAHS
PO Box 875
Murfreesboro, AR 71958



NAME _________________________________________________________________


ADDRESS ______________________________________________________________


CITY _________________________________________________________________                                                                                                                                                          STATE


STATE ______________________________________ ZIP CODE ________________


TELEPHONE (Area Code + Number) _______________________________________


Are you interested in HISTORY _______ GENEALOGY _______ BOTH _______

Please mark one or both of the above. If you are interested in genealogy
please list the Surnames you are researching below or if you need more
space, use a separate sheet of paper and mail along with your membership
application. You are also encouraged to include a Pedigree Chart and
Family Group Sheets with your Membership Application. All surnames
submitted to PCAHS will be placed in our Surname File. Queries submitted
to "THE GEMS" are FREE to members and will be published as space permits.
Please be specific when writing your query regarding names, dates, places
and the information you are seeking.


                     SURNAMES BEING RESEARCHED


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