Please mail this form
and your check to:

LCHGS
PO BOX 1382
OXFORD, MS 38655
__________________________________________________________________

_____Please send me additional information about the Society.

_____Please enroll me (us) as a new member of the Society.

_____Please renew my (our) membership in the Society.

_____I'd like to volunteer for the Society.

Name(s)____________________________________________________

Street______________________________________________________

City______________________State______ ZIP_________ Phone_____________

e-mail address_______________________________________________________

The Names I'm interested in are: ______________________________________

____________________________________________________________________

The days/times I could volunteer are:___________________________________

(This information will never be sold or distributed outside the Society)