|
CGN
Main Page |
|
|
Name:
|
__________________________________________________________ | ||||
|
Address:
|
__________________________________________________________________ | ||||
|
City:
|
_____________________ |
State:
|
_____________
|
Zip+4:
|
_____________ |
|
Home
Phone:
|
_____________________ |
Work
Phone:
|
_______________________________
|
||
|
Email
Address:
|
_____________________ |
Email Event Reminders to you?
|
___Yes ___No | ||
|
Voluntary
Information...
|
|||||
|
Indicate
your membership in similar |
__________________________________________ | ||||
| __________________________________________ | |||||
|
Can
you help with publicity? .........................................
|
___Yes ___No | ||||
|
|||||
|
Facility
for meeting available to you?..........................
|
___Yes ___No | ||||
|
|||||
|
Nearby
Cemeteries to you... (list) .................................
|
_________________________________________ | ||||
| _________________________________________ | |||||
| _________________________________________ | |||||
On the reverse side of this form, let us know about your basic interests in gravestone studies or suggestions that might help to support our objectives.
It would help us organize programs throughout Connecticut if anyone having an association has to a facility that we could use for an occasional meeting or event with our grup. If you do, please let us know. We are also looking for co-sponsor support to promote our annual symposium efforts.
If
there is a tour or other related activity that you could offer to help in
our sharing efforts, please include a description.
____________________________________________________________________________
Annual Dues are $10.00
Please make your check payable to "CGN" and send it with this application to:
CGN c/o Ruth
Shapleigh-Brown
135 Wells Street
Manchester, CT 06040 - 6127