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  Blue Hills Genealogical Society Barron County, Inc
 PIONEER/CENTURY CERTIFICATE APPLICATION
                                                                
Page 2
 

                               Please PRINT or TYPE all entries  

CHILDREN OF PIONEER/CENTURY ANCESTOR (List all children. If there are children from more than one marriage, separate those of each marriage by entering "Children from marriage with _______" before each grouping)

 

NAME

DATE & PLACE

OF BIRTH

DATE & PLACE

OF DEATH

DATE

MARRIED

NAME OF SPOUSE

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

 

EVIDENCE (List all documents submitted to show evidence of settlement and descent) / REMARKS


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