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GenieSpeak - Genealogy Researcher Registration Form
Print form (set printer to portrait). Type or print plainly and send to:
GenieSpeak , %Helen Staiger, 240 Duffy Rd., Slippery Rock, PA. 16057
Fax (724) 794-4627 (press SEND as soon as phone rings or our answering machine may pick-up)
Name:
Address:
Payment Method: $25 One-Time Registration /Setup Fee - Check (payable to Helen Staiger) or PayPal - ________
PHONE: Home#:__________________________Business#:_________________________
E-mail address:_____________________________Fax#:___________________________________
WWW address:____________________________________________________________________
Specialties:
Regional Research Areas:
Research Sites You Visit Regularly:
Research Sites You Visit Periodically:
Other Services You Offer:
OPTIONAL: Free Ad Space (please limit to 50 words or less) Use additional sheet of paper as necessary.
PLEASE NOTE: Include all information as applicable. Mark any items you wish to be kept confidential as such. Otherwise all information will be listed on the website.
HMcS mail@Geniespeak.com