THE LOGAN COUNTY GENEALOGICAL SOCIETY, INC.
PO Box 1419
Guthrie, Oklahoma 73044

APPLICATION FOR PIONEER CERTIFICATE

ELIGIBILITY: Applicant must be a direct descendant of the ‘89er who lived in the unassigned lands in Indian or Oklahoma Territory between April 22, 1889 and September 22, 1891.

FEE: $5.00

TYPE OR PRINT INFORMATION

APPLICANT: ________________________________________________________

                  (name as it will appear on the certificate)

            _________________________________________________________
               (street address)           (city)     (state)   (zip)

NAME OF 89’er:  ________________________________________________________
ORIGINAL LOCATION:  ____________________________________________________
        Date of Birth:  ____________________   Place: ___________________
        Date of Death:  ___________________    Place: ___________________
        Date of Marriage:  _________________   Place: ___________________
        Spouse:  _______________________________________________________
                   (if female give maiden name, if known)

        Date of Birth:  _________________  Place: _____________________
        Date of Death:  _________________  Place: _____________________

Attach machine copy of proof of arrival or residence in the Unassigned Lands
 in Oklahoma or Indian Territory and submit to the Logan County Genealogical
 Society at above address.

List sources of proof as to descent by generations.  Please number
 photocopied proofs to correspond to each generation number.

1.  _________________________________________________________________
2.  _________________________________________________________________
3.  _________________________________________________________________
4.  _________________________________________________________________
5.  _________________________________________________________________
6.  _________________________________________________________________
7.  _________________________________________________________________
8.  _________________________________________________________________
9.  _________________________________________________________________
LINE OF DESCENT CHART

1.  _______________________________ was born on __________________________
          Applicant                              Day        Month     Year

    __________________________            ___________________________
         County                              State

    __________________________
         Spouse


2  Child of _____________________ Spouse  ___________________________
    Born ________________________ Place  ____________________________
    Married  ____________________ Place  ____________________________
    Died  _______________________ Place  ____________________________

3 Child of _____________________ Spouse  ___________________________
    Born ________________________ Place  ____________________________
    Married  ____________________ Place  ____________________________
    Died  _______________________ Place  ____________________________

4 Child of _____________________ Spouse  ___________________________
    Born ________________________ Place  ____________________________
    Married  ____________________ Place  ____________________________
    Died  _______________________ Place  ____________________________

5 Child of _____________________ Spouse  ___________________________
    Born ________________________ Place  ____________________________
    Married  ____________________ Place  ____________________________
    Died  _______________________ Place  ____________________________

6 Child of _____________________ Spouse  ___________________________
    Born ________________________ Place  ____________________________
    Married  ____________________ Place  ____________________________
    Died  _______________________ Place  ____________________________

7 Child of _____________________ Spouse  ___________________________
    Born ________________________ Place  ____________________________
    Married  ____________________ Place  ____________________________
    Died  _______________________ Place  ____________________________

8 Child of _____________________ Spouse  ___________________________
    Born ________________________ Place  ____________________________
    Married  ____________________ Place  ____________________________
    Died  _______________________ Place  ____________________________

PERMISSION FOR PUBLICATION RELEASE

I hereby state that the material submitted with and in this application may
 be used in a published book at a later date.  I also understand that this
 material submitted by me may be used by me should I decide to print it at
 a later date.  I give my permission to the Logan County Genealogical
 Society to use the material submitted and allow it to be edited if 
necessary.


Signature  _____________________________________ Date  ________________

FOR OFFICE USE ONLY

File Number ______________________  Name of 89er  ________________________
date received  ____________________________________________________________
date certificate mailed to applicant  _____________________________________
date application returned for further information  ________________________