LAST NAME ___________________________________________________________
MAIDEN NAME ________________________________________________________
________ FIRST ________________________________________________________
ADDRESS ______________________________________________ APT/UNIT# _____
CITY ______________________________ ST/PROV ______ MAIL CODE _________
Phone ________________________________ Email ____________________________
Membership dues enclosed (Please do not send cash):
$ 8.00 Annual _______ Donation _________
Lineage:
I am in the (Check one) _____ Robert____ Peter _____ Unknown
If you are a Husted descendant, please fill out a biography page and a lineage sheet and return it with the membership application. This will allow us to record you in your proper place in the family tree.
You may now pay useing PayPal
MAIL APPLICATION TO:
Husted Family National Assoc.
38 Evergreen Dr.
St Louis MI. 48880
