History Genealogy Form

-1TOWN

HISTORY GENEALOGY FORM

A new history of Charlestown is in the works! The Charlestown Heritage Commission would like to include ALL the people currently residing in town in the genealogy section, whether or not you are a native of Charlestown. We hope you will take part by completing the form below. Husband Name: (including nickname)

DOB:

Birthplace:

Occupation:

Military Service and Dates:

Wife’s Name:

DOB:

Occupation:

Military Service and Dates:

Birthplace:

Street Address: (please, no post office box numbers) List Children, Dates of Birth, and Spouses: (use an additional sheet, if needed)

Your Parents: Father’s Name (of husband):

Of: (where born or lived)

Mother’s Maiden Name (of husband):

Of: (where born or lived)

Father’s Name (of wife):

Of: (where born or lived)

Mother’s Maiden Name (of wife):

Of: (where born or lived)

If either husband’s or wife’s family is listed in previous Charlestown histories, check which history, list family name and page number: (i.e., Smith, John, pg. 400) ___Saunderson History (check one) ___Frizzell History Any other pertinent or interesting information, to be used as space permits, at discretion

of committee. This could include other marriages and other children, accomplishments of own family or parents, etc.

--------------------------------------------------------------------------------------------------------If husband or wife is not a native of Charlestown, or if the family is not listed in the two previous town histories, please complete this section in addition to the first section. When moved to Charlestown:

From:

Husband, Original immigrant ancestor to America, if known: Immigration Date:

Country of Origin:

Where Settled: Wife, Original immigrant ancestor to America, if known: Immigration Date:

Country of Origin:

Where Settled:

*********************************************************************** * You have the option of leaving blank any question that you prefer not to answer. If you have a question, or would like to mail a form to someone who lived in Charlestown for many years, but no longer resides here, please contact Eric Lutz, 826-5565, or pick up a form at the town offices.