Yes, I want to sign-up for Family Papers exciting new service and take advantage of your Special Internet Registration Offer ($18.95 per ancestor for 1 year). Here's the information you need:

Customer Information (Please Print)

Name: _______________________________________________________________

Address: ______________________________________________________________

City: ____________________________________ State: _________ Zip: ___________

E-Mail Address: ____________________________ Fax: (_____)__________________

Home Phone: (_____)__________________ Work Phone: (_____)__________________

How Did You Hear About Family Papers: _____________________________________

Ancestor Information (Please Print)

Sex: Male ( ) Female ( )

First Name: _________________________________ Middle Name: ____________________

SURNAME: ________________________________ (Maiden Name):___________________

Title/Rank (if Applicable): ________________________

Birth Date (Day/Month/Year): _____________________________________

Birth City: ______________________________________ State/Country: ________________

Date of Death (Day/Month/Year): __________________________________

Death City: _____________________________________ State/Country: ________________

City/Location of Primary Association: _____________________________________________

State/Country of Primary Association: _____________________________

Primary Occupation During Life: _________________________________________________

Other Pertinent Information Regarding Your Ancestor: _________________________________

___________________________________________________________________________

Return this completed form to: Family Papers, PO Box 230086, Tigard, OR 97223 along with a check for $18.95 per registered ancestor.

For questions call: (503) 968-6595, (503) 968-6365 (fax), or E-Mail familypapers.com


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This page last updated: 16 January 1997