Membership Form

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Current Dues

Annual Dues, $10 per individual and $25 for corporate member. Dues payable to the Treasure, Cornish Cousins of the South East. Payable on fiscal year starting 1 June.

Note: Due to start-up expenses dues for 2001 will be $15.

Fill out form, print, then mail with check or money order to:

Cornish Cousins of the Southeast
Attn: William E. Paul
150 Upper Browns Creek Road
Burnsville, N.C. 28714

Asterisk *marked items are Required


Street No.*



Zip Code*

Complete rest of form if you want your name added to the Members Interest Directory
E-mail Address:

Home Page URL:

Surname Interests:
List "Surname" (In Capitols Please) Comma "Time Period" Comma "Location", One Name Per Line Please.