L 'Association des Hébert du Monde

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          Membership Chairman: Randy Lege', P. O. Box 1523, Abbeville, LA 70510
                                            
                      We Invite You To Join     -    L'Association des Hébert du Monde

Annual membership is valid from January 1 through December 31 each year.  All members in good standing will receive the Association's newsletter [La Gazette HÉBERT], and free admittance to family reunions held by the association.
                                                       
Membership Application

Type of Membership (circle one):        Single ......$5.00 per year          Family ...........$5.00 per year

Member's Full Name (Nom)(person who is Hebert descendent):
 _____________________________________________________________________________
   Last 
(Nom de famille)               First (prenom)            Maiden/Middle(deusiemme prenom)
If you go by a name other than the first name listed above, please indicate here__________________

Parent's Full Names (Hebert):________________________________________________________

Grandparent's Full Names (Hebert):___________________________________________________
(If you have more information on your ancestors, please send on separate sheet or on back of this form)

Spouse's Full Name_______________________________________________________________
       
(espoux/epouse) Last (Nom de famille)            First (prenoum)      Maiden/Middle   (deusiemme prenom)

Address: (Adresse):______________________________________________________________
                                  Street 
(Rue)                       P O Box (boite postal)

City (Ville)______________________State (Etat)____________Country (Pays)______Zip:______

Home Phone:(       )_____________________Work Phone:(        )___________________________

FAX:________________________________E-Mail:___________________________________

Other family members in your household:
Name:___________________________________  Relationship to member:__________________
List Others on back of Appllication

Please make checks payable to:  Hébert Family Association, and mail to:
   Randy Lege'
P O Box 1523
  Abbeville, LA 70511