MEMBERSHIP APPLICATION FORM
                                       
   
   
   Genealogical Association of Nova Scotia
   3045 Robie St., Suite 222
   Halifax, Nova Scotia  B3K 4P6
   Canada
   
   Please print and mail this form to the above address.

   Note: GANS can also now accept membership applications and renewals electronically
   with payment by credit card or Paypal.
   
   I wish to apply for membership in The Genealogical Association of Nova
   Scotia.
   
   NAME_____________________________________________________________
   
   ADDRESS__________________________________________________________
   
   CITY______________________ PROVINCE/STATE________________________
   
   POSTAL/ZIP CODE______________ 

   TELEPHONE___________________ e-mail address_______________________
   
   Enclosed: $30.00 membership fee for the calendar year 2012.
   
   Applicants outside Canada please remit by cheque or money order 
   payable in U.S. Funds.
   
   Optional donation to the Development Fund: $________ 
   (A Canadian charitable income tax receipt will be sent)
   
   [ ] Check this box if you do NOT want your name and address published in the on-line
       searchable version of the GANS Directory of Members and Surname Interests or in the NSG.
   
   Check one of the following options:
   [ ] I wish to have access to the NSG in electronic format.
   [ ] I wish to receive the NSG in paper format.


   Surname Interests                    Locality

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   Personal Web Site URL  http://_______________________________________________
   Contains information on the following Nova Scotian Families

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