Please Print and Mail with appropriate fee to the address below:
 
 
 

  Swan Hill Genealogical & Historical Society Inc.
  PO Box 1232
  Swan Hill  Vic  3585

  Surname: ______________________________

  Title: Please Circle one - Mr.  Mrs.  Ms.

  Given Names: ___________________________________________________

  Year of Birth:  _______________

  Occupation:  ____________________________________________________

  Postal Address: __________________________________________________

  Postcode: __________________

  Telephone: Home:(     )_________________    Work:(     ) _________________

  Fax:(     ) __________________Email: ________________________________

Declaration: I accept to be bound by the Purposes, Rules and By-Laws of the Society

Signature: _________________________________
 
 

Graphics by: Jelane
Cemetery Headstone Background by:  Papagei
WebPage by Helen
Page Updated 10 November 2000