MEMBERSHIP APPLICATION for the GERMAN AMERICAN CITIZENS ASSOCIATION

I wish to join the German-American Citizens Association and herewith enclose my remittance (check or money order) of $_______________ for the year 2010.
I understand that with the receipt of my membership card I will be entitled to all privileges of membership and will abide by all conditions of membership as stated in the By-Laws.

Name______________________ _________________________ ____________________

(last name) (first name) (spouse)

Address__________________________________________________________________

City_______________________ State _____________________ Zip Code __________________

Phone No._______________________

Country of Birth_____________________________ _________________________________
Husband Wife

Occupation__________________________________ ____________________________________

Name and age of children under 19_______________________________________________

E-mail_____________________________________

Signatures of sponsors (two GACA members – separate memberships)

________________________________________

________________________________________

Signature ________________________ Date________________