This is a questionnaire to collect or correct family genealogical information. My records are not complete in some areas and questionable in other areas. Your help will be greatly appreciated. Please enter anyone (Parent, Grandparent, Great Grandparent, Child) as Person 1. There is a comment box at the bottom if you have additional comments about any of the previous boxes or if you have any questions in general. You will receive a copy of this information when you send it to me by clicking on the button at the bottom of the form.

Your Full Name (required)

Your Email Address (required)

Full Name (maiden name if female) of Person 1 (required)

Date of Birth of Person 1

Place of Birth of Person 1

Date of Death of Person 1

Place of Death of Person 1

Father of Person 1

Mother of Person 1

Full Name (maiden name if female) of Spouse of Person 1

Date of Birth of Spouse

Place of Birth of Spouse

Date of Death of Spouse

Place of Death of Spouse

Father of Spouse

Mother of Spouse

Marriage date of Person 1 and Spouse

Marriage place of Person 1 and Spouse

Add any general comments about the above boxes in the box on the right. For example, how you are related to the above individuals (I may not know this), the name of the cemetery where they were buried, etc.

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