Kerr Family Association of North America Membership Form
Email address *
Date *
MM
/
DD
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YYYY
Are you renewing? *
Full Name (First and Last) *
Family members included in family membership
Address (Street, *
Telephone *
Kerr ancestor's name *
Kerr ancestor's birthdate
Kerr ancestor's birthplace
Would you like to receive your newsletter electronically? *
Membership Type & Payment (A link to Paypal payment will follow after hitting "Submit.") *
Required
A copy of your responses will be emailed to the address you provided.
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