Membership Application

ALDEN KINDRED OF AMERICA, INC. Preliminary Application - Web Site Version Click Here for a Printable Version for Submission The Alden Kindred of America, Inc.     /    Alden House Historic Site Application for Membership Date ____________________________ Name (print clearly): _____________________________________________________________                                                   First                     Middle                                   Maiden                              Last Business Name__________________________________________________________________ Your Occupation ________________________________________________________________ Spouse’s Name (print clearly): ______________________________________________________ (If Applicable)                                         First                     Middle                                   Maiden                              Last Spouse’s Occupation _______________________________________________________________ Your Date of Birth________________________Spouse’s Date of Birth________________________ Residence________________________________________________________________________ Seasonal Residence (please indicate dates________________________________________________ _______________________________________________________________________________ Telephone Number _________________E-mail address ___________________________________ Child’s Name_____________________________________________ DOB____________________(If Applicable)         First                     Middle                                Last Child’s Name_____________________________________________ DOB____________________ Child’s Name_____________________________________________ DOB____________________ How did you learn about the Alden Kindred? Relative (Name) ____________________________________ACW #___________________ Another Society (Name)_______________________________________________________ Visit to Alden House Historic Site _______________Approximate Date___________________ Web site___________________________________________________________________ Other (please explain) _________________________________________________________ Signature of Applicant _____________________________________________________________ 5  I am interested in becoming a Lineage member. My synopsis and additional application fee are   enclosed. 5  I am interested in becoming a Lineage member at a later date. To join, print and complete this application and send it with your check or money order (payable to the Alden Kindred of America, Inc.) to Alden House Historic Site, P. O. Box 2754, Duxbury, MA  02331-2754.  Questions or comments, please call 781-934-9092 or email to   membership@alden.org For Office Use Only Please indicate type of membership you are applying for: Date Rec'd Entered in QB Check #       Check Amt Entered in DB Acknowledged __________ __________ __________ __________ __________ __________ ___ Individual   ___ Family   ___ Business