Questionnaire

Your Name: _________________________________________Your e-mail address:__________________________
INSTRUCTIONS: Answer as many of the following questions as you can. If you have documents that confirm your answers (i.e.) birth, marriage or death certificates, etc., check the box that follows the question.

1.       What is your father's full name?q _______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
2.       When was your father born? q_________ Where? (Town)__________(County/Parish)__________(State/Country) ____

(If foreign born, indicate when and where he entered the U.S.) When? q:­­­­­­ ­­­­­________Whereq: _______________________

3.       Name other places your father has lived.q_____________________________________________________________

4.       If your father is deceased when and where did he die?q When: ____________ Where:________________________

5.       What is your mother's full maiden name?q _____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________
6.       When was your mother born? q ________ Where? (Town)__________(County/Parish)_________(State/Country) ____

(If foreign born, indicate when and where she entered the U.S.) When? q:_______ Where? q:­_______________________

7.       Name other places your mother has lived q_____________________________________________________________

8.       If your mother is deceased, when and where did die? q When?:____________  Where?:_________________________

9.       When and where did the union of this couple occur? q When?:____________   Where?:________________________

10.    If either had other spouses, indicate: His other Spouse: q_____________ Her other Spouse: q____________________

(If applicable: Date and place of other marriage/union: q Date:___________ Place:_______________________________

CONCERNING YOUR PATERNAL GRANDPARENTS (Your father's parents)

11.    What is your grandfather's full name?q_____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

12.    When was your g-father born? q________Where? (Town)__________(County/Parish)_________(State/Country) ____

(If foreign born, indicate when and where he entered the U.S.) q When?:__________Where?:________________________

13.    Name other places your g-father has lived?q___________________________________________________________

14.    If your g-father is deceased when and where did he die? When?:______________ Where?: ______________________

15.    What is your grandmother's full maiden name?q ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

16.    When was your g-mother born? q________ Where? (Town)__________(County/Parish)_________(State/Country) ___

(If foreign born, indicate when and where she entered the U.S.) When? q__________Where?:­q_______________________

17.    Name other places your g-mother has lived

18.    If your g-mother is deceased, when and where did die? q When?:____________ Where?:_ _________________________

19.    When and where did the union of this couple occur? q     When?:____________  Where?:________________________

20.    If either had other spouses, indicate: His other Spouse: q ­­­­­_______________ Her other Spouse: q__________________

(If applicable: Date and place of other marriage/union: q Date:____________     Place:_____________________________

CONCERNING YOUR MATERNAL GRANDPARENTS (Your mother's parents)

21.    What is your grandfather's full name?q___________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

22.    When was your g-father born? q_________Where? (Town)__________(County/Parish)_________(State/Country) ___

(If foreign born, indicate when and where he entered the U.S.) When: q___________Where: q_______________________

23.    Name other places your g-father has lived?q___________________________________________________________

24.    If your g-father is deceased when and where did he die? When?:______________ Where?: _______________________

25.    What is your grandmother's full maiden name?q _______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________

26.    When was your g-mother born? q________ Where? (Town)__________(County/Parish)_________(State/Country) ___

(If foreign born, indicate when and where she entered the U.S.) When?: q_______________Where?:­q_________________

27.    Name other places your g-mother has lived

28.    If your g-mother is deceased, when and where did she die? q When:___________________ q Where:______________

29.    When and where did the union of this couple occur? q     When?:____________  Where?:________________________

30.    If either had other spouses, indicate: His other Spouse: q ­­­­­_______________ Her other Spouse: q __________________

(If applicable: Date and place of other marriage/union: q Date: ____________    Place:_____________________________