Membership or Subscription Form

Membership (newsletter + Members Only website): $14.00 US per calendar year.

Subscription (newsletter only): $10.00 US per calendar year. (Gift subscriptions can be purchased.)

If Please print this form, fill it out, and mail it with the correct amount to the address given below.
CCFHA Member Application & Profile Form

Name: ________________________________________

Address: ______________________________________

Address2: _____________________________________

City: _________________________________________

State: ____________________________

Zip code: _____________

Country, if not U.S.: _____________________________

E-mail address: ______________________________________

Birthday (month & day): _________________________

Your CCFHA Family Division No. (if known): ________
   Your Corson (or related surname) line of ancestors:

How would you like to receive the newsletter?  Electronic (by e-mail) ______   Paper (by mail) ______ 

Other comments:


Send this completed form to: CCFHA, c/o Gale Corson, 434 Nikki Drive, Santa Rosa, CA, 95401.

Remember to include a check or money order (made out to "CCFHA") for the correct amount (U.S. dollars).