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Subscription Form

The Schürch Family Association

of North America

NEWSLETTER SUBSCRIPTION ORDER FORM

The newsletter is published in April and November. If ordering from the United States, please mail your check or money order, in U.S. funds, to the U.S. Treasurer. If ordering from Canada, please mail your cheque or money order, in Canadian funds, to the Canadian Treasurer. Get a price break by ordering a two or three-year term.

Term

One year

Two years

Three years

Canadian Treasurer:

Laurine Mills

1750 Killaly St. E.

Port Colborne, Ontario, Canada L3K 5V3

U.S. Treasurer:

Jack Sherick

126 Depot Place, 1st Floor,

Nyack, NY, USA 10960

Please print your name and address carefully and indicate the length of term for which you are paying. If you would like to send the newsletter to other family members, please include the additional names and addresses and note the length of term. Make your cheque/check or money order payable to The Schürch Family Association.

Name ___________________________________________ Phone ______________________

Address ______________________________________________________________

City ______________________________ State/Province _______________________

Country ______________________________ Zip/Postal Code _____________________

Length of Term __ year(s)

Name ___________________________________________ Phone ______________________

Address _______________________________________________________________

City ______________________________ State/Province _______________________

Country ______________________________ Zip/Postal Code _____________________

Length of Term __ year(s)