Scottish & Irish Society
of the Black Hills
Membership Form
Family $30 Individual $20
Date: New: Renewal:
Name:
Address:
City, State, Zip:
Telephone:
Email:
Irish: ___ Scottish: ___ Welsh: ___ Cornish: ___ Manx: ___ Other:
______________
Clan or Family affiliation: _______________________________________
What interests or skills do you have (history, genealogy, music, dancing,
cooking, other...)?
Total amount enclosed: $ _______
Please make checks payable to "Scottish & Irish Society"
or just "SIS".
Mail your check and completed membership form to:
Scottish & Irish Society of the Black Hills
PO Box 765
Rapid City, SD 57709