Membership Application

Junkins Family Association

APPLICATION FOR MEMBERSHIP

Membership in the Junkins Family Association is open to anyone who has an interest in the purposes of the association. Descendants of Robert Junkins (1621-1699) and his wife, Sarah Smyth (1645-1718) are particularly welcome.


Name:

Spouse's Name:

Children's (Living at Home) Name(s):

Address:

City:

State:

Zip:

Phone No.:

E-mail Address:

[ ] $10 Individual [ ] $35 Contributing
[ ] $15 Family [ ] $75 Sustaining
Historical and Memorial Marker Fund Donation $
Total Enclosed $

Please mail your check or money order to:
THE JUNKINS FAMILY ASSOCIATION

Ann H. Cheney, Vice President
46 Sibicky Road
Griswold, CT 06351

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