Full name of applicant______________________________ Citizen of ______________ Address________________________________________________________________________ Applicant was born in________________________on_____________ Is the son/daughter of 2.________________________________________born in_____________________________ on_________________and died in________________________________on_______________ and__________________________________his wife, born in_________________________ on_________________and died in________________________________on_______________ Married in_____________________________on________________________that the said ___________________________________________was the son / daughter of: 3.________________________________________born in_____________________________ on_________________and died in_______________________________on_______________ and__________________________________his wife, born in_________________________ on_________________and died in_______________________________on_______________ Married in_____________________________on________________________that the said ___________________________________________was the son / daughter of: 4.________________________________________born in_____________________________ on_________________and died in_______________________________on_______________ and__________________________________his wife, born in_________________________ on_________________and died in_______________________________on_______________ Married in_____________________________on________________________that the said ___________________________________________was the son / daughter of: 5.________________________________________born in_____________________________ on_________________and died in_______________________________on_______________ and__________________________________his wife, born in_________________________ on_________________and died in_______________________________on_______________ Married in_____________________________on________________________that the said ___________________________________________was the son / daughter of: 6.________________________________________born in_____________________________ on_________________and died in_______________________________on_______________ and__________________________________his wife, born in_________________________ on_________________and died in_______________________________on_______________ Married in_____________________________on________________________that the said ___________________________________________was the son / daughter of: 7.________________________________________born in_____________________________ on_________________and died in_______________________________on_______________ and__________________________________his wife, born in_________________________ on_________________and died in_______________________________on_______________ Married in_____________________________on________________________that the said ___________________________________________was the son / daughter of: 8.________________________________________born in_____________________________ on_________________and died in_______________________________on_______________ and__________________________________his wife, born in_________________________ on_________________and died in_______________________________on_______________ Married in_____________________________on________________________that the said ___________________________________________was the son / daughter of: 9.________________________________________born in_____________________________ on_________________and died in_______________________________on_______________ and__________________________________his wife, born in_________________________ on_________________and died in_______________________________on_______________ Married in_____________________________on________________________that the said ___________________________________________was the son / daughter of: 10.________________________________________born in____________________________ on_________________and died in_______________________________on_______________ and__________________________________his wife, born in_________________________ on_________________and died in_______________________________on_______________ Married in_____________________________on________________________that the said ___________________________________________was the son / daughter of: 11.________________________________________born in____________________________ on_________________and died in_______________________________on_______________ and__________________________________his wife, born in_________________________ on_________________and died in_______________________________on_______________ Married in_____________________________on________________________that the said ___________________________________________was the son / daughter of: 12.________________________________________born in____________________________ on_________________and died in_______________________________on_______________ and__________________________________his wife, born in_________________________ on_________________and died in_______________________________on_______________ Married in_____________________________on________________________. Ancestor is (no.__): ____________________________________________________SERVICE OF ANCESTOR - Give dates and particulars for lineage society qualification.
Names Date of Birth To whom married (noting if married more than once)_______________________________ _____________ ______________________________
PROOF OF DESCENT
(title, author, page, Bible record, public records, or other sources)
2nd Generation: ___________________________________________________________
________________________________________________________________________
________________________________________________________________________
3rd Generation: ___________________________________________________________
________________________________________________________________________
________________________________________________________________________
4th Generation: ___________________________________________________________
________________________________________________________________________
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5th Generation: ___________________________________________________________
________________________________________________________________________
________________________________________________________________________
6th Generation: ___________________________________________________________
________________________________________________________________________
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7th Generation :___________________________________________________________
________________________________________________________________________
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8th Generation: ___________________________________________________________
________________________________________________________________________
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9th Generation: ___________________________________________________________
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10th Generation: __________________________________________________________
________________________________________________________________________
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11th Generation: __________________________________________________________
________________________________________________________________________
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12th Generation: __________________________________________________________
________________________________________________________________________
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I married ______________________________on_____________at_________________
born _____________________ son/ daughter of ________________________________
My children____________________________born___________at_________________
______________________________________born___________at_________________
______________________________________born___________at_________________
______________________________________born___________at_________________
______________________________________born___________at_________________
______________________________________born___________at_________________
BIOGRAPHICAL DATA
(Including education, career, military service, lineage societies, church affiliations,
and other items of interest to your descendants)
Phone__________________Signature________________________Date_____________
Proposer _____________________________ Seconder __________________________
http://www.execpc.com/~sril/apply.html --- --- March 22, 1998 --- --- Comments to DrG@execpc.com.