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FAIRFIELD COUNTY PIONEERS
503 Lenwood Dr, Lancaster, OH 43130-2261


INSTRUCTIONS TO APPLICANT: Fill in sections A, B, and C on this page. List your main ancestral line on pages 2 and 3, beginning with your self as #1. Type or write all information legibly. A check written to The Fairfield County Chapter OGS in the amount of $20.00 must accompany this application. Application must be postmarked no later than 1 November.


[A]

Applicant's Name Street Address County

__________________________________________________________________________

Full Name of Husband or Wife City State Zip Code

__________________________________________________________________________

 

[B]

PIONEER(S) IN FAIRFIELD COUNTY, OHIO BY 31 DECEMBER 1820

Name of Ancestor Document as to Settlement--Doc #

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

___________________________________________________________________________

[C]

Fairfield County Chapter of The Ohio Genealogical Society dues are paid for 200_.


FCP COMMITTEE USE

Date Received ___________________

Application Fee __________ *non-refundable Approved ______________
FCP Member # ____________ President _______________


1.

I,________________________________ was born on_______________________________ at City____________________________ County__________________ State___________ married on_________________________ to_______________________________________ at_________________________________________________________________________

2.

I am the child of_____________________________________________________________ born on_______________________________ at__________________________________ died on_______________________________ at__________________________________ and his ( ) wife______________________________________________________________ born on_______________________________ at__________________________________ married on_____________________________ at _________________________________

3.

The said____________________________ was the child of_________________________
born on________________________________ at ________________________________
died on________________________________ at ________________________________
married on______________________________ at________________________________

4.

The said____________________________ was the child of_________________________
born on_____________________________ at___________________________________
died on_____________________________ at___________________________________
married on___________________________ at __________________________________

5.

The said____________________________ was the child of_________________________
born on_____________________________ at___________________________________
died on_____________________________ at___________________________________
married on___________________________ at __________________________________

6.

The said____________________________ was the child of_________________________
born on_____________________________ at___________________________________
died on_____________________________ at___________________________________
married on___________________________ at __________________________________

7.

The said____________________________ was the child of_________________________
born on_____________________________ at___________________________________
died on_____________________________ at___________________________________
married on___________________________ at __________________________________

8.

The said____________________________ was the child of_________________________
born on_____________________________ at___________________________________
died on_____________________________ at___________________________________
married on___________________________ at __________________________________

9.

The said____________________________ was the child of_________________________
born on_____________________________ at___________________________________
died on_____________________________ at___________________________________
married on___________________________ at __________________________________

10.

The said____________________________ was the child of_________________________
born on_____________________________ at___________________________________
died on_____________________________ at___________________________________
married on___________________________ at __________________________________

 

DOCUMENTATION

Please read and use the RULES OF EVIDENCE when preparing this page of documentation. You must include a five generation chart for each person you submit. We suggest you use "Cite Your Sources" by Richard S. Lackey (New Orleans, Polyanthos, Inc., 1980) as a guide. Most libraries have a copy of this publication available.

List documents used for each generation

Doc #_______ Description of document________________________________________

Doc #_______ Description of document________________________________________

Doc #_______ Description of document________________________________________

Doc #_______ Description of document________________________________________

Doc #_______ Description of document________________________________________

Doc #_______ Description of document________________________________________

Doc #_______ Description of document________________________________________

Doc #_______ Description of document________________________________________

Doc #_______ Description of document________________________________________

Doc #_______ Description of document________________________________________

Doc #_______ Description of document________________________________________

Doc #_______ Description of document________________________________________

Doc #_______ Description of document________________________________________

Doc #_______ Description of document________________________________________

Doc #_______ Description of document________________________________________

Doc #_______ Description of document________________________________________

Doc #_______ Description of document________________________________________

Doc #_______ Description of document________________________________________

Doc #_______ Description of document________________________________________

Doc #_______ Description of document________________________________________


I do/do not (circle one) give my permission to the Fairfield County Chapter of The Ohio Genealogical Society to furnish information contained in this application to other members seeking the same surname.

I do/do not (circle one) give my permission to the Fairfield County Chapter of The Ohio Genealogical Society to request publication rights for Bible records, wills, partitions and other interesting documents that may be included with this application.

I, _____________________________________do hearby swear that the statements set forth in this application, are true to the best of my knowledge and belief.

 

Signature of Applicant___________________________________ Date _______________

 

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1995-2005 Fairfield County Genealogical Society