Membership Application

New and Renewal Membership Application

To register on line use our form below. PayPal accepts MasterCard, Visa, Discover or American Express cards.
If you prefer not to order online, click here for a printable form. NOTE: Credit cards can only be accepted online.
Once you registration has been processed, you will receive an email with your log in user name (your email address) and password to be able to enjoy the free materials on the PCGS Passport / Member Login page.

Note: if you have any problems, please email the pcgstreasurer (at) gmail.com.

"*" indicates required fields

Please choose one*

New Membership (Period From July 1st until June 30th)

Renewal Membership (Period From July 1st until June 30th)

Name*

First Middle (used for security) Surname

Address*

Street Address City State ZIP (12345-1234)

Email*

Enter Email Confirm Email

*Email is required to receive newsletters, passport access, & notifications. We will never share your your email address.

Primary Phone*

Cell Phone

Birth Date*

Employer

Surnames Researching

Class of Membership Desired*

$30.00 Regular Membership - One or more persons of the same household, under 65

$30.00 Regular Membership - Organization devoted to the pursuit of genealogy

$25.00 Senior Membership - At least one member of the same household, over 65

$50.00 Contributing Membership - Regular or Senior wishing to pay dues plus a contribution to Peoria County Genealogical Society

$100.00 Sustaining Membership - Regular or Senior wishing to pay dues plus a contribution to Peoria County Genealogical Society

Additional Donation to PCGS (Undesignated)

Additional Donation to Library/Microfilm Fund

Additional Donations are much appreciated. Thank you!
PCGS is a 501c(3) organization.
Donations support our mission and are tax deductible.

Yes, please!

Total

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Phone

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Peoria County Genealogical Society