DELAYED BIRTH FILE ORDER FORM

BLAIR COUNTY GENEALOGICAL SOCIETY
431 SCOTCH VALLEY RD.
HOLLIDAYSBURG, PA. 16648

NAME: _________________________________________________________

ADDRESS: _____________________________________________________

CITY, STATE, ZIP: ________________________________________________

The following must be filled in from the Delayed Birth Record Index

http://www.bcgslibrary.org/birth-index.html

Only those records listed in the index are available, but not every person listed
in the index has a file on the microfilm.

Last Name: ______________________________________________________

First Name: ______________________________________________________

Middle Name: ____________________________________________________

Date of Birth: _____________________________________________________

File Number 1663 - ________________________________________________

Microfilm Reel Number: _____________________________________________

Files are usually about 2-5 pages in length. Suggested donation per birth file: $5

Donation Amount Enclosed: _________________________________________