New Member Application Form

Midwest Afro-American Genealogical Interest Coalition (M.A.G.I.C.)

New Member Application Form

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M.A.G.I.C. MEMBERSHIP APPLICATION
Membership runs January 1st through December 31st

$20 - Individual:_____New______Renewal
$30 - Corporate:______New______Renewal

Date: ________________________

Name:____________________________________

Address:__________________________________

City:_____________________________________

State:____________________________Zip:_____________

Area Code:(_____)Phone Number:_____________

E-mail Address:____________________________________

Do you hold a membership in another area or local genealogical society? If yes, please list the name below:

_____________________________________________

Please make check payable to:

M.A.G.I.C.

and mail to:

M.A.G.I.C.
P.O. Box 300972
Kansas City, MO 64130