New Member Form 2015 Membership Year Runs from January 1

NEW MEMBER FORM 2015 MEMBERSHIP YEAR RUNS FROM JANUARY 1 – DECEMBER 31

If joining by mail send this form to: GESHER GALICIA, INC., C/O BEN TYSCH, 407 N. MCCADDEN PLACE, LOS ANGELES, CA 90004 USA

Or join online by going to: http://www.geshergalicia.org/join-gesher-galicia/ .

Enter ALL of the information below and then either print and snail mail (or scan and email) this form and send to Ben Tysch at the address above or to: [email protected]. On this form (or online) you can add donations to Galicia's general fund, GARP (Galician Archival Records Project) Town Projects or GG General Fund, the All Galicia Database, the Tarnopol Census or other special projects.

Membership Dues (per year), and Optional Donations: Paper Delivery of The Galitzianer (select one): eMail Delivery of the Galitzianer Amount ☐ US and Canadian Residents $42 ☐ All Locations $36 $ ☐ Residents outside US or Canada $49

Optional donations to support Gesher Galicia or specific projects (check any you wish to support) Gesher Galicia, Inc., is a 501(c)(3) not for profit corporation. Donations are tax deductible in the U.S.

☐ Gesher Galicia General Fund $ ☐ All Galicia Database (supports additional province-wide indexing) $ ☐ Galician Archival Records Project (GARP) general fund $ Tarnopol 1910 Census Project $180 for access to original census images OR $100 for Excel file and 25 image scans $______ GARP – Galician Archival Records Project (GARP) Town Projects: Donations in any amount are Town name______$______welcomed, but $50 (minimum) to access digital images of records & $250 to start a new town project, Town name ______$______to which GG adds $250 in matching funds. GRAND TOTAL $______

YOUR NAME:______ADDRESS: ______CITY, STATE, COUNTRY, ZIP: ______EMAIL: ______GG Membership # (if known) ______

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☐ Check here if you DO NOT WANT your information published in the Gesher Galicia Family Finder. If you select this option, neither your name, your contact information, nor your research interests will be available to other members of Gesher Galicia.

SURNAMES & PLACE NAMES YOU ARE RESEARCHING

List surnames and towns that you are researching for inclusion in the online Gesher Galicia Family Finder. (You have the option of emailing this information to Ben Tysch if you are joining by PayPal/Credit Card.) You can mail this form, or scan and email to: [email protected]

IMPORTANT TO NOTE: Places that were not in historical Galicia will not be listed. If you are not sure about your towns or regions, check JewishGen’s Jewish Community Database: http://www.jewishgen.org/communities/search.asp. To guarantee accuracy GG will standardize the place names and may make corrections to what you provide. Since many town names in Galicia sound alike, if you know the coordinates (longitude/latitude) and/or historic administrative district of current oblast/powiat in Ukraine or Poland for your town(s) please add that information below to assist us. If you don't yet know the towns, we can still list your research surnames in the Family Finder. Just indicate "town not yet known." If you need assistance with this process contact Renee Steinig at: [email protected].

Place name and modern country: Poland or Ukraine (If you know the Administrative Surname(s) associated with the place name as given in the left column District or coordinates add those)

Check here if you DO NOT WANT your information published in the Gesher Galicia Family Finder. If you select this option, neither your name, your contact information, nor your research interests will be available to other members of Gesher Galicia. Remember that the Family Finder is not accessible to the public online, but only to GG members who are signed onto our site with a password.

More information on donation levels: Gesher Galicia has so much going on, donation information can be confusing! Gesher Galicia's All Galicia Database and Map Room are both free search engines. Once we complete indexing records or stitching maps, we upload the results for free access. Specific project donations, however, will get you extra benefits (or early access), including password access to digital images of archival record books or Excel spreadsheets with data for an entire town. For existing town projects, a $50 minimum donation is required to view record images and Excel files. The more that is donated, the further we can continue our work. For new GARP projects we need a starting donation of $250, but this can come from one person, or several contributors with smaller amounts that add up to $250. (We can help you with networking among landsleit.) If you are not sure about the status of a town project, check our Inventory or contact Shelley Pollero at: [email protected]. For GARP specifics read our info page: http://www.geshergalicia.org/projects/garp/