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Welcome to the ClanSomerville.net Membership Form and Survey. We will use this form for establishing a mailing list and to create a "master" database of Somervilles in the future. In addition, it will be used to determine if there is any interest among Somervilles to establish our Clan as an official Association. We welcome your comments and suggestions. Currently the web site is maintained by annual voluntary contributions of $15 (US), which includes your own unique "@ClanSomerville.net" domain email address, your personal web site listed and linked in our upcoming directory of Somerville related sites, and reunion postings. If you appreciate the content of the site and would like to help keep it's web presence alive, please send your contribution to:

David Somerville, 1157 Corral Road, Prescott, Arizona, 86303 USA

MEMBERSHIP FORM & SURVEY

Please fill in the form below as accurately as possible. If you have any comments, please reserve them for the space provided. You may make a copy of this form for other Somervilles not contacted by our Clan Secretary.
Last Name : First Name: MI:
Street Address or PO Box:
Street Name:
City: State/Province:
Postal Code:
Tele: Country Code: Area Code: Phone#:
E-Mail Address:
1) Number of People In Immediate Family:
2) Names of Immediate Family Members Living in Your House:
3) How related to a "Somerville" (parents, grandparents, uncle, aunt, cousin, etc.):
4) Clan activities interest:
Committee Clan Council
Officer Publicity
Highland Games Newsletter
Reunions Website
Geneology    
Other:
5) What do you recommend to be the cost of individual yearly membership?
$10 $15 $20
6) What do you recommend to be the cost of immediate family membership?
$20 $25