Member Information

    First Name: 
     Last Name: 
Street Address: 
          City: 
         State: 
  Zip Code + 4: 
     Telephone: 
           FAX: 
        E-mail: 
          Year: 
 Surnames and subjects for genealogical exchange:
 
 Geographical location:
 

Type of Membership

Select which type of member you wish to become:

Individual Membership ($30.00/Year)
Family Membership ($40.00/Year)
Student Membership ($15.00/Year)
Institutional Membership ($40.00/Year)
Life Membership ($300.00) 

Application Submission

Once you click on the "Register" button, your application will be submitted via e-mail to the Society. Please promptly remit the appropriate dues amount by mail to:
Tulpehocken Settlement Historical Society
116 N. Front St., PO Box 53
Womelsdorf, PA 19567-0053