Felshtin Society Membership Application

The Felshtin Society is a tax-exempt organization. Please print out this form, complete it, and mail it along with your check for $25 annual dues payable to The Felshtin Society to: Sid Shaievitz, 299 Glenwood Avenue, Bloomfield, NJ 07003; (973) 743-7753; telecopier (973) 743-7717.

Note: A list of your Felshtiner friends and relatives will help expand our network of Felshtiner landsleit.

Name: ________________________________________________

Spouse's Name:________________________________________________

Address:______________________________________________________

City/Town_________________________________________

Home Telephone ___________________________________

Business Telephone:________________________________

E-mail:_______________________________

Felshtin Family Name(s):__________________________________________

Please check any of the volunteer activities in which you would be interested in participating:
__ Archival Research	I can read Yiddish:
__ Cemetery Restoration
__ Felshtin Archives	___ Very Well
__ Fund Raising	___ Good
__ Legal Matters	___ A Little
__ Meetings and Hospitality	___ Not at all
__ Membership
__ Newsletter Contributions
__ Yizkor Book Publication
__ Yizkor Book Translation