Mail Merge Gateway

Butler County Researchers Family Data

DO NOT USE THIS FORM IF YOU ARE ONLY REGISTERING A SURNAME
Instead return to the Web Site and enter the Surname Page.
You will find a form there for the purpose of registering your family surname.

The Information In The Data Posted Here
Is To Assist You And Others
Researching Butler County Family History

The blanks with *** must be filled in

THINK BEFORE YOU SUBMIT ANY INFORMATION
REMEMBER THE PRIVACY OF THOSE WHO ARE LIVING.

*** - SURNAME: - ***
LAST NAME FIRST
With Given Names and Nick Name:

BIRTH: Place and Date

DEATH: Place and Date

SPOUSE and DATE MARRIED:
LAST NAME FIRST

BIRTH: Spouse Place and Date

DEATH: Spouse Place and Date

Resided in Butler County - Township and Year

*** Your E-mail address: ***

YOUR NAME:

THANK YOU

The basic design of this form was created by : [email protected] Patty (c) 1999
With Patty's permission The form is modified and placed here by: Mary Hudson,
This form generated by mailMerge.
If you have a problem please contact me at [email protected] Mary
- May 01, 1999 -

Note: You will be taken to a screen called mailMerge Gateway to view your entry. Simply click on your browser's back key and you will return here. Click the browser's back key again to return to Web Site.

Lincoln D. Stein
Whitehead Institute for Biomedical Research