Membership User Registration "*" indicates required fields Membership PlanIndividual MembershipInstitutional MembershipFamily MembershipLifetime Individual MembershipLifetime Family MembershipName* First Last Address* Street Address City State ZIP Code Mobile Number*Email* Home NumberBirthday MM slash DD slash YYYY Are you a member of any other genealogy groups?*Are you a member of any other genealogy groups?YesNoIf you are a member of other genealogy groups, please list them belowPlease share with us, your business background and/or professional experience.ADDITIONAL MEMBER INFORMATIONName (Additional Member) First (Additional Member) Last (Additional Member) Address (Additional Member) Street Address City State ZIP Code Mobile Number (Additional Member)Email (Additional Member) Home Number (Additional Member)Birthday (Additional Member) MM slash DD slash YYYY I give my permission to publish my email, address and phone number to BFGHS members/website.* Yes No Media Release Permission I give Black Family Genealogy and History Society (BFGHS) and people acting for and with BFGHS permission to interview, photograph, video, and/or audio record me to use and to edit, without compensation to me, the items listed below in any medium, including print and electronic (webbased) material for educational, promotional and marketing purposes:Photographs video or any virtual platform footage of me* Agree Disagree Spoken (written or recorded) interviews of me and quotes from me* Agree Disagree My full name in connection with the photographs, video footage, interviews, or quotes* Agree Disagree My location in connection with the photograph(s), video footage, interviews or quotes* Agree Disagree I will make no monetary or other claims in connection with the authorized use of my name or photos, video, interviews, and quotes, and I now release Black Family Genealogy and History Society and partner organizations and their partners in education, promotion, publicity and marketing interviews from any claims, demands and liabilities in connection with the use authorized and agreed to here by me.This field is hidden when viewing the formMember CodeSURNAME INFORMATION (Enter NA if not applicable)Surname*State*County*City*Time Period*Maternal/Paternal*Select Payment Method Paypal Check payments Zelle Payments Make payable to BFGHS. Your receipt from your order email should be attached to the check and mailed to P.O Box 75654 Phoenix, AZ 85087.Zelle payments can be sent to 'treasurer@bfghs.org'Payment Method
