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Membership Application for the Herrick Family Association

Membership fees are $20 per calendar year. If you join after June 1st, it is $10 for your first year. If you join after November 1st your $20 is applied to the next calendar year. Beginning in January 2007 the following additional membership options have been added: 2 years $38; 5 years $80; Lifetime for those over 50 $400.

Send your dues and completed application to Dale Yoe, 13390 Windrush Court, Solomons, MD 20688.

Name: _____________________________

Street Address: ______________________________

City, State, Zip Code: ____________________________

E-mail address: ______________________________

Phone Number: ______________________________

Other members of my family are:_________________________________________________

_________________________________________________________________________

_________________________________________________________________________

How are you related to Henry of Salem? __________________________________________

Where would you suggest a future meeting be held for the Association?

__________________________________________________________________________

Would you be willing to host a future meeting?

__________________________________________________________________________