Crest of the Bukovina Society of the Americas The Bukovina Society of the Americas
P.O. Box 81, Ellis, KS 67637, USA 
Martha McClelland , President  info@bukovinasociety.org
Bukovina Society Headquarters & Museum, Ellis KS 67637

Home Up What's New? Site Map Genealogy & Contacts Families/Villages Culture & Customs Library Newsletters Map Room Web Museum Store Search Other Organizations Guest Book About This Website Auf Deutsch


Membership-Application-Form
(Secure online credit card payments accepted thru PayPal -
Sichere Kredit Karte Bezahlung durch PayPal )

For more information about the Bukovina Society of the Americas, please see About Us.  For additional information about membership, please see Membership Information.

If you would like to join the Bukovina Society of the Americas, please complete the form below. 

 

Membership Type:

 Select Membership Type:
New Membership
 
 Select Membership Length:
$15.00  1 Year Membership
 
Renewal $150.00 Lifetime Membership

Payment Method:


Select Payment by Check:
 Payment by Check

Please note: Foreign Checks or Money Orders must be pre-printed with "US FUNDS"

Select Payment by Credit Card at PayPal:


PayPal accounts are available in these countries:
Personal Information:

First Name:

Spouse:

 

Middle Initial:


Middle Initial:
 
Last Name


 
 
Street Address


 
 
City                                                State                          Postal/ZIP Code

          
 
 
Country:


 
 

Telephone:


Email Address*

 

*International Members: The Newsletter will be emailed to this email address. 

Genealogy Interests
Ancestral Names of Interest


 
 
Ancestral  Villages of Interest


 

 

Topics of Interest:
√ Check all that apply:
Culture
Genealogy
History
 
Add additional areas of interest:
Other:
Other:
Other:
 

Genealogy Section Access
(USER NAME and PASSWORD
will be emailed  upon receipt
of membership payment)

 


Request Access Authority to Genealogy Section
:

   No, I do not wish to have access to the Genealogy Section at this time.  I understand I may ask for this at a later time.

  Yes, please email to me my USER ID and PASSWORD to access the genealogy section.

   Anti-SPAM Control: Please enter "1843" / Bitte eintragen "1843"

 

 

If the information above is correct, please enter SUBMIT below.  Additional payment instructions are on the next page.
This may take a minute; please do not submit twice.     

 

 

Hit Counter Visitors since January 17, 2003                            Last Revised: 12/19/11 08:24:30 AM

Beech Tree Leaf

Copyright 1991-2011, Bukovina Society of the Americas

 

About-this-website.html