Membership to
the Polk County Cemetery Preservation Committee is open to anyone
who shares the goal of preserving the cemeteries in Polk County. Print the application, and return to us via U.S. Mail with membership dues.
Polk County Cemetery Preservation Committee Membership dues:
Name:________________________________________________________________________________________________
(Last) (First) (Middle or Maiden)
Mailing Address: ______________________________________________________________________________________
City:______________________________________________________State:______________Zip:_____________________
Occupation:___________________________________________________________________________________________
Phone #:___________________________________________ Birth Month & Day _________________________________
E-mail address:_____________________________________________________________
Polk County Cemeteries where you have family buried: __________________________________________________________
_______________________________________________________________________________________________________
______________________________________________________________________________________________________
______________________________________________________________________________________________________
Polk County Cemetery surveys that you have compiled: __________________________________________________________
______________________________________________________________________________________________________
______________________________________________________________________________________________________
Do you have a Personal Computer? If so, would you be willing to help with typing for the Project?________________
Skills & Talents (Typing, Photography, Art, Public Speaking, Leadership etc): ______________________________________
______________________________________________________________________________________________________
______________________________________________________________________________________________________Suggestions for the Project: _______________________________________________________________________________
______________________________________________________________________________________________________
Please return this form to:
Post Office Box 213
Cedartown, Georgia 30125
Individual - $20 per year
Life Time - $100 at one time