Clan Montgomery Society International
Membership Application and Renewal Form
( Renewing Members, Please Include Your Full Name, Address and CMSI Number )
This membership is:    (   ) New      (   ) Renewing      (   ) Gift (see below)

Name of Member/Applicant/Recipient___________________________________________________________ CMSI No._________

Street Address__________________________________________________________ City___________________________________

State_________________ Zip Code____________ Country_____________________________________ Phone_________________

E-Mail Address________________________________________________________________________________________________

I would like to receive The Gardien newsletter by E-Mail to receive it quicker and in color:      (    ) YES      (    ) NO

Applicant's Occupation_________________________________________________________________________________________

Spouse’s Name and Occupation__________________________________________________________________________________

Montgomery Relation, or
Reason for interest in Clan Montgomery___________________________________________________________________________

How did you hear about Clan Montgomery?   (   ) Relative    (   ) Website    (   ) Highland Games    (   ) Other_________________

Please indicate your Area of Interest

   (   ) Contribute to The Gardien Newsletter    (   ) Hosting Clan Tents    (   ) Helping in the Genealogy Arena

   (   ) Helping with Annual General Meetings    (   ) Other___________________________________

Dues for the Society are from January 1 to December 31 of the year in which you join, and are renewable each January. Members who join from January to September will receive Society newsletters published during that period of time. Joining from October to December includes membership for the entire following year. Membership is open to those interested in the purposes to which Clan Montgomery Society is dedicated. If you wish to enroll friends or relatives, please fill out a separate application for each. New members will be listed in the CMSI newsletter, The Gardien. Dues and contributions are tax deductible.

Gift From:____________________________________________________________________________________________________

Your CMSI No. (if applicable)____________ Street Address__________________________________________________________

City______________________________________________________________________ State________________ Zip___________

Annual Dues for USA Member/s, Individual or Couple________$25.00                      ________Life Membership, $300

Annual Dues for Non-USA Members/s, Individual or Couple________$30.00 USD   ________Life Membership, $350 USD

Enclosed is my check/Money Order made payable to Clan Montgomery Society in the amount of $___________________

Signature ____________________________________________________________________________ Date ___________________

Please mail this form with your check/Money Order made out to Clan Montgomery Society to:
Karen D. Luster, Treasurer
Clan Montgomery Society of North America
6679 Clarkes Meadow Dr
Bealton, VA 22712-6953 USA

Form Last Updated: June 28, 2020