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Applicant Information

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Last Name*

Company Name

Address*

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Email Address*

Website

Do you provide genealogical services?
Select one: yesno

Are you currently accepting clients?
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Do you manage record collections?
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If yes, for which organization?

Website Listing*

We publish a listing of members’ names, contact information and research services on our website. Please select one of the following three options:
Please list my name, contact information and services on the CPGC websitePlease do not include me on your websitePlease include my name and services on the CPGC website, but allow me to specify which fields display

Do Not Display Street AddressTown/State/ZipPhoneEmail

Research services: Please list your research services as you would like them listed on the website. (120 character limit)

Volunteer Opportunities

Let us know if you would like to
Distribute CPGC brochures in your areaVolunteer with NERGCParticipate in our Ancestor Road Show

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Click the SUBMIT APPLICATION button to submit the form and advance to payment options.