LOOKUP REQUEST FORM
Not for obituary orders. If you have an exact death date, use the
PAGE ONE OF TWO PAGES
BLAIR COUNTY GENEALOGICAL SOCIETY
ROLLER-HOJETH MEMORIAL LIBRARY
431 SCOTCH VALLEY ROAD
HOLLIDAYSBURG, PA 16648
Please type or print legibly.
NAME: ___________________________________________________________
ADDRESS: _______________________________________________________
CITY/STATE/ZIP: __________________________________________________
DATE: ___________________________________________________________
EMAIL ADDRESS: _________________________________________________
Please check the following BCGS publications or library resources
1. _______________________________________________________________
2. _______________________________________________________________
3. _______________________________________________________________
4. _______________________________________________________________
for the following information I wish to find:
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
_________________________________________________________________
I ENCLOSE
$ ___________ DONATION TO THE SOCIETY
(plus 40 cents per page for each expected photocopy; send S.A.S.E. or postage).
PLEASE GO TO PAGE TWO, PRINT AND FILL OUT THE CHART AND
INCLUDE IT WITH YOUR REQUEST.
