You must be a member of the Belmont County Chapter/OGS
INSTRUCTIONS TO APPLICANT: Fill in sections B, D, E, and F on this page. List your main ancestral line on Page 2 beginning with your self as #1. Type or write all information legibly. A check for $15.00 (non-refundable) must accompany this application.
| BCGS USE ONLY 1._____________________ 2. ____________________ 3. ____________________ 4. ____________________ 5. ____________________ 6. ____________________ 7. ____________________ 8. ____________________ 9. ____________________ 10. ___________________ 11. ___________________ | | [B] Name: ____________________________ (Filled in by applicant) First Families of BCGS Number _________ Date application Received _____________ Acceptance Date __________ Fee Received _____________ |
| [D] | Applicant's Name _______________________________ Full Name of Husband or Wife ____________________________ |
| Street Address ____________________________________________ | |
City _______________________ County _________________ State _________________ Zip Code _______ Telephone: (___) __________________ Email:____________________________________________________ |
[E] ANCESTORS WHO WERE SETTLED IN BELMONT COUNTY BEFORE 1831
| Name of Ancestor | Year first proved in Belmont County | Twp first proved in Belmont County | State or County Ancestor came from |
[F] My Belmont County Genealogical Society dues are paid for the year _______ .
[G] BCGS Verification __________| First Families of BCGS Committee Chairman ________________________ | Date ____________ |
| BCGS Executive Board Chairman ________________________________ | Date ____________ |
| BCGS President _____________________________________________ | Date ____________ |
| 1. | I, | ||||
| was born on | at City | County | State | ||
| 2. | I am the child of | ||||
| born on | at City | County | State | ||
| died on | at City | County | State | ||
| and | his wife | ||||
| born on | at City | County | State | ||
| died on | at City | County | State | ||
| married on | at City | County | State | ||
| 3. | The said was the son or daughter of | ||||
| born on | at City | County | State | ||
| died on | at City | County | State | ||
| and | his wife | ||||
| born on | at City | County | State | ||
| died on | at City | County | State | ||
| married on | at City | County | State | ||
| 4. | The said was the son or daughter of | ||||
| born on | at City | County | State | ||
| died on | at City | County | State | ||
| and | his wife | ||||
| born on | at City | County | State | ||
| died on | at City | County | State | ||
| married on | at City | County | State | ||
| 5. | The said was the son or daughter of | ||||
| born on | at City | County | State | ||
| died on | at City | County | State | ||
| and | his wife | ||||
| born on | at City | County | State | ||
| died on | at City | County | State | ||
| married on | at City | County | State | ||
| 6. | The said was the son or daughter of | ||||
| born on | at City | County | State | ||
| died on | at City | County | State | ||
| and | his wife | ||||
| born on | at City | County | State | ||
| died on | at City | County | State | ||
| married on | at City | County | State | ||
| 7. | The said was the son or daughter of | ||||
| born on | at City | County | State | ||
| died on | at City | County | State | ||
| and | his wife | ||||
| born on | at City | County | State | ||
| died on | at City | County | State | ||
| married on | at City | County | State | ||
| 8. | The said was the son or daughter of | ||||
| born on | at City | County | State | ||
| died on | at City | County | State | ||
| and | his wife | ||||
| born on | at City | County | State | ||
| died on | at City | County | State | ||
| married on | at City | County | State | ||
Signature of Applicant _________________________________ Date ___________
*I do not give my consent to Belmont County Chapter, OGS and First Families of Belmont County to furnish information in this application to others.
*I do not give my consent to Belmont County Chapter, OGS and/or First Families of Belmont County to publish the information contained in the Ancestor Chart (s) I have submitted.
I, ________________________________ do hearby swear or affirm that the statements set forth in this application, are true to the best of my knowledge.
Signature of Applicant _________________________________ Date ___________
| Mail completed application, ancestor chart(s) and $15.00 application fee (non-refundable) to: | |
| Belmont County Chapter OGS - First Families | |
| PO Box 285 | |
| Barnesville, OH 43713-0285 | |
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