GENEALOGY SOCIETY

Client's Name (*reqd.): *


Client's Email (*reqd.): *


Ancestor's name:


Approx. year of Birth:


Place (if known):


Ancestor's father (if known):


Ancestor's mother (if known):


Their approx. year of marriage (if known):


Year of marriage of ancestor:


Wife/husband’s name (if known):


Children of ancestor (some or all):


Firstborn (if known):


Others:


Year (s) of birth (where known):


Religion:


Period of emigration:


Other information (including place names & other general information):