LOOKUP REQUEST FORM

Not for obituary orders.  If you have an exact death date, use the

Obituary Order Form.

 

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 followingBCGS 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.