Rock Co. Genealogical Society: Ancestral Surname Submission Form

ROCK COUNTY GENEALOGICAL SOCIETY

RCGS MEMBERS' ANCESTRAL SURNAME SUBMISSION FORM
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Instructions: (1) Print This Form (2) Fill-Out, and (3) Mail to RCGS, PO 936, Janesville, WI 53547-936

Membership in the Rock County Genealogical Society allows you to submit your Family Surnames along with geographic, immigration and date information along with email or postal contact information. This information is then posted to the RCGS web site (see sample below). Then others researching your surnames can contact you to share their research, photos and family stories.

SAMPLE (note: a greater-than sign “ > ” shows immigration from one place > to another place)

SURNAMES	TIME FRAME	VILLAGE, CITY, TOWNSHIP	COUNTY	STATE or PROVINCE	COUNTRY	CONTACT INFO.*
BRADFORD	1875 - 1950	Clintonville	Waupaca Co. (WI)	MA > WI	England > USA	pat672@yayoo.com
DARRAH	Before 1950	La Prairie Twp.	Rock Co. (WI)	NY > WI	USA	pat672@yayoo.com
OEHRKE	January, 1870	Edgerton > Beloit	Rock Co.	WI	Germany > USA	Arthur@hotmail.com
LASHER	Circa 1880	Racine	Racine Co.	WI	USA	MaryF@netcom.com
LANPHIER	After 1910	Albion	Dane > Rock Co.	WI	USA	C.Smith, 101 Main Str. Janesville, WI 53545

ADD YOUR FAMILY INFORMATIOM BELOW (BLOCK PRINT PLEASE!)

SURNAMES	TIME FRAME	VILLAGE, CITY, TOWNSHIP	COUNTY	STATE or PROVINCE	COUNTRY	CONTACT INFO.*

*Provide an email address as contact information (email addresses disguised on the web page), or you may provide a postal address instead.

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