Print out and mail this form to add your name to the Society's address list. You are also most welcome to become a Member of the National Icarian Heritage Society. Membership Dues are the Society's only source of funds to maintain its publications and other programs such as the growing genealogical data base of original Icarian families and their descendants.
Mail to:

National Icarian Heritage Society
Dee Symens, NIHS Treasurer
7515 Sands Terrace Lane
Spring, TX 77389
Name
Street
City, State, Zip
Telephone
e.mail address:
If descendant, give name of Icarian ancestor(s)
Interests: (check all that apply)
□ Mailing List   □ Membership   □ Educational
□ Historical □ Genealogy      □ Other (specify) _______________
If you would like to join the National Icarian Heritage Society at this time, indicate desired level of dues payment below:
□ My check covers the $20 Regular Member dues for the current calendar year.
□ My check covers a $50 payment for dues and to become a Supporting Member*
□ My check covers a $100 payment for dues and to become a Distinguished Member.*
□ My check covers a $300 payment for dues and to become a Life Member (owing no future dues)*
* Note: The National Icarian Heritage Society has been granted tax exempt status by the IRS under Section 501 (c) (3). Our Federal Tax I.D. No. is 43-1377491. Consequently all contributions over and above the basic $20 dues are tax deductible.

Please make check payable to: National Icarian Heritage Society