The Jersey County Historical Society Membership Application
Name:_________________________________________________________________________
Street address or Box # ___________________________________________________________
City, State, Zip___________________________________________________________________
E-mail Address___________________________________________________________________
Your website URL if applicable_______________________________________________________
Phone number with prefix: __________________________________________________________
Surnames you are researching: ______________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
_______________________________________________________________________________
Lifetime Membership per person is $150.00
Annual Membership per person is $15.00
AMOUNT PAID ___________
Make checks payable to: Jersey County Historical Society
Address: Jersey County Historical Society
601 North State Street
Jerseyville, Illinois 62052
Phone: 618 498 3514
Your yearly membership dues pays for your seasonable newsletter, we will publish four times a year. With
research, printing and postage, it is about a break even deal