Please Print  &  Mail to:
Attention Certificate Committee
Downriver Genealogical Society, Box 476, Lincoln Park, MI 48146
The Downriver Genealogical Society
Descendants of Downriver Certificate Application

(Start Page 1)   Instructions to applicant: Fill in all blanks, page 1
                          and page 2, beginning with yourself as #1. Type or
                          print all information in black ink. A check or money
                          order for $5.00 must accompany the application.

A. Applicant’s Name
_______________________________________________________
(as it will appear on the certificate)
_______________________________________________________
(street address)
_______________________________________________________
(city, town, village

B. Name of ANCESTOR___________________________________
(name of qualifying ancestor who was in Downriver prior and through
185-, 1851-1900, or 1901-1930 as it will appear on certificate. Circle
appropriate time period.)

Birth______________________________________ Death__________________________________
         (date)                                               (place)                                   (date)                                           (place)

Baptism___________________________________ Buried__________________________________
              (date)                                          (place)                                   (date)                                           (place)

Married__________________________________________________________________________
              (date)                                                                            (place)

SPOUSE_________________________________________________________________________
                (name)                                                                     (maiden, when applicable)

Birth_____________________________________ Death___________________________________
         (date)                                                (place)                              (date)                                                 (place)

Where in Downriver did ancestor settle?__________________________________________________

Emigrated from_____________________________________________________________________
(if known)           (township)                    (county)                                    (state, province/country)

Proof of arrival date__________________________________________________________________
_________________________________________________________________________________

I hereby grant the Downriver Genealogical Society permission to print the informaton on this application,
for a possible future publication.  

YES__________  NO__________     Signature_____________________________________________

Example of LINE OF DESCENT CHART from APPLICATION SHEET (females use maiden name)

1.  I, (name)          Betty J. Kauffman                  was born on (date)      5 Sept. 1933                                              
     
       at (place)      Wyandotte              (county)          Wayne          (state)            Michigan                                     

        married to (spouse)           Edward J. Schley                                                                                                        

2.   Child of   Clarenc T. Kauffman       married to            Hazel E. Bushroe                                                            
                      Born      7 Mar. 1903           Place     Ford City, Wayne Co., MI.
                      Married   20 June 1923     Place     St. Patrick, Wyandotte, MI.
                      Died       18 Apr. 1961        Place     Trenton, Wayne Co., MI.

3.   Child of   Edward L. Kauffman       married to         Margaret H. Meloche                                                         
      etc.

LINE OF DESCENT CHART

START PAGE 2

1.   I,  (name)________________________________   was born on _________________

      at  (place) __________________(county) ____________ (state)_________________

      married to   (spouse)____________________________________________________

2.   Child of _______________________  married to______________________________
                   Born                                          Place
                   Married                                     Place
                   Died                                          Place
3.    Child of _______________________  married to______________________________
                   Born                                          Place
                   Married                                     Place
                   Died                                          Place
4.     Child of _______________________  married to______________________________
                   Born                                          Place
                   Married                                     Place
                   Died                                          Place
5.      Child of _______________________  married to______________________________
                   Born                                          Place
                   Married                                     Place
                   Died                                          Place
6.      Child of _______________________  married to______________________________
                   Born                                          Place
                   Married                                     Place
                   Died                                          Place
7.       Child of _______________________  married to______________________________
                   Born                                          Place
                   Married                                     Place
                   Died                                          Place

List sources of proof as to descent by generation (please number photocopied proofs to
correspond to generation numbers).

1.________________________________________________________________________

2.________________________________________________________________________

3.________________________________________________________________________

4.________________________________________________________________________

5.________________________________________________________________________

6.________________________________________________________________________

7.________________________________________________________________________

Reminder: EACH STEP MUST BE PROVEN!                    Date Sent____________________

__________________________________________________________________________
   (signature of applicant/submitter)

__________________________________________________________________________
(address if different from page 1

Return to DRGS Home Page   Email webmaster
Submit to: Downriver Genealogical Society, Box 476, Lincoln Park, MI 48146.