THE KANSAS INSTITUTE FOR
AFRICAN AMERICAN AND NATIVE AMERICAN
FAMILY HISTORY
MEMBERSHIP FORM
Name ______________________________________________________________________
Street address: _______________________________________________________________
City _____________________________________________________ State ____Zip______
home tel. ( ) ____________home fax no ( )_________ work tel.( )_________________
email address: _______________________________________________________________
(email address will not be shared, and used only for our own communications with you)
MISSION: Our mission is to promote the preservation, documentation and celebration of family identity, traditions, achievements, and connections of the members of the African American and Native American communities of the Mid-West.
INTERESTS: (put a C if you can contribute expertise and H if you want to GET HELP with as many of the following as apply): genealogy research techniques and resources______ ; own family history _________; documenting historic ___ and or current _____ relations between African American and Native peoples; documenting 19th century African American settlement or presence in Mid-West_____; African American and/or Native American culture and traditions ______; other: ____________________________________________________
COMMITTEE: (check one or two you would feel most comfortable assisting with)
Public relations and outreach________; Newsletter/Publishing __________
Fund Raising (networking_________ , proposal development ______, events______)
Membership recruitment__________; Membership services _________
PURCHASE of KIAANAFH produced items: Transcription of the 1870 Pension Census of the Cherokee Nation that was lost in the national archives until recently. It is available on CD to members for $30 (including shipping - $35 for non-members) or in print form for $22.50 (in either surname alphabetized or original order of entry. $25 for non-members.) Transcription of our own 1998 Kansas City workshop on historic ties between several member families with Native American peoples. ( $10 including shipping for members only, $15 for non-members.)
PAYMENT: make check payable to KIAANAFH and send with this form to
Edith Walker,
492 Beacon St. # 76,
Boston, MA 02115.
Membership and extra contributions are tax deductible. Purchases are not.
(family membership is $25/yr ___) (#___ CD or #___ printout of Roll=$____)
(#____WorkshopTranscription=$____) (extra contribution = $_________)
TOTAL included = $_______. check no.______