CONFERENCE REGISTRATION FORM

NAME ______________________________________________________________________

ADDRESS __________________________________________________________________

CITY ________________________________________________________________________

STATE ____________________________ ZIP ____________________________________

TELEPHONE ________________________________________________________________

EMAIL _______________________________________________________________________

ARE YOU A MEMBER OF A GENEALOGY OR HISTORICAL SOCIETY?

SOCIETY NAME: ____________________________________________________________

FAMILY SURNAMES YOU ARE RESEARCHING:

1. ______________________________________________

2. ______________________________________________

3. ______________________________________________

4. ______________________________________________

COST:

Before May 20, 2020

__________ Society Member $55.00

__________ Non-Member $60.00

After May 20, 2020

__________ Society Member $60.00

__________ Non-Member $65.00

Mail this form with your payment to:

KCGS Conference
PO Box 47903
Wichita, KS 67201-47903