Polish Genealogical Society of Michigan
Mailing Address

Burton-Detroit Public Library/Dept W
5201 Woodward Ave
Detroit, Michigan 48202-4007 USA
Registration Form

Seminar Registration - 2019
When: Saturday, October 19, 2019, 9:00 am to 4:00 pm ~~ Sign-In Begins at 8:30 am ~~ Where:  American Polish Cultural Center, 2975 E. Maple Rd. (15 Mile Rd.) at Dequindre Rd., Troy, Michigan 48083 ~~ Included: Two Speakers, Four presentations, Speaker Handouts, Continental Breakfast, Polish Lunch, and door prizes.

We are providing a new payment  option for Seminar Attendees who wish to pay by check/money order.  Fill in all the required fields below. If you do not have an email address you must enter the following in that field:  none@noemail.com
Mailed registration forms must be POSTMARKED no later than October 5, 2019 - NO Exceptions
Email registration will close on October 5th, 2019 - NO Exceptions
Ancestral surnames and villages will be included in the seminar syllabus.
In the Human Verification area, click the box and you will be given a code to enter into the required field.  Click "Submit Registration".  
The next page will be your "Registration Confirmation", at the bottom of the form choose either Print & Mail with Check or Buy Now.
Attendees mailing in check/money order can pickup their syllabus on the day of the seminar those paying by credit/debit card will receive a link to download and print their syllabus. Don't forget to bring your printed syllabus with you  as we will not have extra printed copies available.
Personal Information:
First Name:  Required
Last Name:  Required
Address:  Required
Address 2:
City:  Required
State / Province:  Required
Postal Code:  Required
Phone (Home or Cell):  Required, Formatted as (000) 000-0000
Email:  Required
Registration (select one):
  Electronic   Printed (color)
Syllabus: $65.00   $75.00
Please make a selection.
Ancestral Information:
  If you would like to have your ancestral surnames and locations included in the Seminar syllabus, complete the sections below:
List Ancestral Surnames:
Enter all surnames followed by a comma.
List Ancestral Locations:
Enter all locations followed by a comma.
PGSM Related:
Is this your first PGSM Annual Seminar?: Yes   No
Please make a selection.
Are you a PGSM Member?: Yes   No
Please make a selection.

Human Verification to Submit Order:
Click the small checkbox below. You will receive a security code. Enter it into the "Required" field. Continue by clicking "Send Registration".
On the next screen, you will receive a "Thank You" notice with payment options. Payment can be made by check with mail-in form or by credit/debit card of your choosing via PayPal.
Check box & enter code:   Required