Text Box:  
Membership Application or Renewal
 
To:   Frank X. Shelley, Treasurer         
        726 Chapel Hill West
        Horsham, PA 19044
Enclosed is my check for $10.00, made out to the Van Zandt Society for a one-year membership. I understand this entitles me to a copy of each Van Zandt Record as it is published (typically Winter, Spring, and Fall).
 
Name: _________________________________________  Phone:    (_____)__________________
                                                                                             
Address :_______________________________________  Email:    _________________________
 
City/State/Zip:     __________________________________________________________________
 
Name of your earliest Van Zandt Ancestor (if known): _____________________________________