DUNHAM/SINGLETARY FAMILY CONNECTIONS

Membership Application

If you or any of your acquaintances are interested in becoming a member, please provide the  information requested below.  We may already have most of the information; however, we would like to verify everything before we begin to use it.

Name:  ___________________________________________

Street Address:  ____________________________________

Town/City:  _________________________________________  Mailing code:  _________________

State, province, etc. ___________________________  Country:  _____________________________

Telephone:  ____________________________

E-mail:  ____________________________________

Web-site _____________________________________________________

Services which might be provided by the organization:

Individual talents, abilities and desire to participate::

Comments:

Please mail with check for annual membership of $25 US to:

Dunham/Singletary Family Connections
PO Box 7178
Helena, MT  59604-7178

Paul C. Dunham
465 Vigilante Drive
Helena, MT, USA 59602-0234
(406) 443-3283
pcdunham@msn.com