Genealogical Research Form
Manchester Historical Society
175 Pine Street Manchester, CT 06040
Email: email@example.com Telephone: 860-647-9983
In order to assist the Manchester Historical Society in performing this Genealogical Research effort, the Society
requests that you be aware of the following...
• Please type or print clearly the information on this form.
• The basic research fee is $20 for Members and $25 for Nonmembers, and is limited to two hours of research.
• Research will include up to 8 photocopies.
• Additional research hours will be charged at the rate of $15 per hour.
• Additional copies will be billed at 25 cents per page.
• You will be contacted before additional charges are incurred.
• Fees incurred in the course of the research (such as for Death Certificates) will be charged as incurred.
Mail this form along with payment to the address above.
Requests will be answered in the order they are received. Please allow 4 – 6 weeks.
Your Name: ________________________________________________________________
City: _________________________________ State: _______ ZIP: __________
Telephone: ______________ Email Address: __________________________________
Name of Person to be researched: __________________________________________
(One name per sheet; include middle name or initial)
Birth Date and Location: __________________________________________________
Marriage Date and Location: _______________________________________________
Death Date and Location: __________________________________________________
Years in Manchester: _________ (e.g., 1920-1947)
Nationality / Religion: ___________________________________________________
Name of Spouse: ___________________________________________________________
Birth Date and Location _____________________________________________
Death Date and Location _____________________________________________
(List any additional spouses on a separate sheet)
Names of Children: _______________________________________________________
Please tell us what you would like to know. The more information you provide will help us avoid unnecessary research. Attach additional sheets as necessary.