Clan
McCord Society
Application for Membership
Note: The New Member Application Fee is $10.00 plus the annual dues of $15.00 for a total of $25.00 to join. Please print this page and fill it out completely.
Today's Date:____________________
Full Name and Alias_________________________________________________________
Home Address________________________________________________________________
City, County, State, ZIP____________________________________________________
Internet Address________________@___________________________________________
Phone_________________________ FAX_______________________________________
Place and Date of Birth________________, __________________________________
Occupation and Company (if retired, give previous calling)__________________
Business Address____________________________________________________________
Full Name of Spouse_________________________________________________________
Spouse's Place and Date of Birth and Occupation_____________________________
Names, Dates and Places of Birth of Children________________________________
____________________________________________________________________________
(Please use reverse if more space is
needed.)
I would be willing to volunteer to help with the
following: qHighland
Games
qRecruiting
Members qNewsletter qResearch
qComputerize Data for Researchers
qOther___________________________________
Father's Full Name and Date of Birth________________________________________
Mother's Full Name and Date of Birth________________________________________
Earlier and Other Ancestors_________________________________________________
Please make your $25.00 check payable to Clan McCord Society and send to:
Clan McCord Society
P.O. Box 471
Leola PA 17540-0471
Member of COSCA, the Council Of Scottish Clans and Associations, Inc.