Application for Membership in the Kelsey Kindred
An Association of Descendants of William Kelsey, the Puritan Ancestor
Organized September 15, 1928

I, the undersigned, hereby make application for a descendant or associate (please circle one) membership in The Kelsey Kindred. I am enclosing the amount of $5.00 dollars for application
fee plus $10.00 for dues.

  __________________
Date of birth
   ________________________________
Full name (including middle name)
   __________________
Date signed
  
  __________________
Street address
   ________________________________
City, State, Zip
   __________________
Signature
  

Please furnish information called for below, or as much as possible, if a descendant, or you believe you are a descendant furnish names of yourself and spouse on last line, and names of parents on next line above, then grandparents, etc.

Generation 1
WILLIAM KELSEY
 and
UNKNOWN
Generation 2__________________________________ and _____________________________
Generation 3__________________________________ and _____________________________
Generation 4__________________________________ and _____________________________
Generation 5__________________________________ and _____________________________
Generation 6__________________________________ and _____________________________
Generation 7__________________________________ and _____________________________
Generation 8__________________________________ and _____________________________
Generation 9__________________________________ and _____________________________
Generation 10__________________________________ and _____________________________
Generation 11__________________________________ and _____________________________
Generation 12__________________________________ and _____________________________
Generation 13__________________________________ and _____________________________
Generation 14__________________________________ and _____________________________
Generation 15__________________________________ and _____________________________
Generation 16__________________________________ and _____________________________
Generation 17__________________________________ and _____________________________

Approved for: Descendant Membership     Associate Membership
    Date ____________________     Genealogist ________________________________

When completed please mail to our Membership Secretary:
Mrs. Suzanne Kelsey Hall :: 244 Mountain Road :: North Granby, CT 06060

FORM MA-1.1 — REV. 05-11-2008