Membership Application for Ringerike - Drammen Districts Lag
Dues are $12.00 per year, $33.00 for 3 years or $50 for five years.    
Membership Year Jan. 1 to Dec 31

Please print this form, fill out and mail to address below
Name

Date

   Renewing Member [  ]        <--   Check one  -->       New Member[   ] 

Street

Phone
City

Email
State and Zip Code


.
Family Origin Information

Family origin in R-DD if known - circle only one.
Ringerike, Hole, Modum, Øvre Eiker, Nedre Eiker, Hurum, Lier, Røyken, Drammen

Ancestor's Given Name & PatronymicFarm NameBirth parish if knownYear Emigrated


   


   


   

May we include your information in our R-DD member database? Yes___ No___
Mail with check payable to Ringerike - Drammen Districts Lag to
Barb Gulbrandsen
1579 Lorane Lane
White Bear Lake MN  55110