You must be a member of the Belmont County Chapter/OGS
INSTRUCTIONS TO APPLICANT: Fill in sections B, D, E, and F on this page. List your main ancestral line on Page 2 beginning with your self as #1. Type or write all information legibly. A check for $15.00 (non-refundable)�must accompany this application.
| BCGS USE ONLY 1._____________________ 2. ____________________ 3. ____________________ 4. ____________________ 5. ____________________ 6. ____________________ 7. ____________________ 8. ____________________ 9. ____________________ 10. ___________________ 11. ___________________ | | [B] Name: ____________________________ �������������������(Filled in by applicant) First Families of BCGS Number _________ Date application Received _____________ Acceptance Date __________ Fee Received _____________ |
| [D] | Applicant's Name _______________________________ �� Full Name of Husband or Wife ____________________________ |
| � | Street Address ____________________________________________ |
| � | City _______________________ ��County _________________ ��State _________________ ��Zip Code _______ Telephone: (___) __________________ Email:____________________________________________________ |
[E] ANCESTORS WHO WERE SETTLED IN BELMONT COUNTY BEFORE 1831
| Name of Ancestor | Year first proved in Belmont County | Twp first proved in Belmont County | State or County Ancestor came from |
| � | � | � | � |
| � | � | � | � |
| � | � | � | � |
| � | � | � | � |
| � | � | � | � |
| � | � | � | � |
[F] My Belmont County Genealogical Society dues are paid for the year _______ .
[G] BCGS Verification __________| First Families of BCGS Committee Chairman ________________________ | Date ____________ |
| BCGS Executive Board Chairman ________________________________ | Date ____________ |
| BCGS President _____________________________________________ | Date ____________ |
| 1.� | I, | ||||
| � | was born on | at City | County | State | |
| � | |||||
| 2.� | I am the child of | ||||
| � | born on | at City | County | State | |
| � | died on | at City | County | State | |
| � | and | his wife | |||
| � | born on | at City | County | State | |
| � | died on | at City | County | State | |
| � | married on | at City | County | State | |
| � | |||||
| 3.� | The said was the son or daughter of | ||||
| � | |||||
| � | born on | at City | County | State | |
| � | died on | at City | County | State | |
| � | and | his wife | |||
| � | born on | at City | County | State | |
| � | died on | at City | County | State | |
| � | married on | at City | County | State | |
| � | |||||
| 4.� | The said was the son or daughter of | ||||
| � | |||||
| � | born on | at City | County | State | |
| � | died on | at City | County | State | |
| � | and | his wife | |||
| � | born on | at City | County | State | |
| � | died on | at City | County | State | |
| � | married on | at City | County | State | |
| � | |||||
| 5.� | The said was the son or daughter of | ||||
| � | |||||
| � | born on | at City | County | State | |
| � | died on | at City | County | State | |
| � | and | his wife | |||
| � | born on | at City | County | State | |
| � | died on | at City | County | State | |
| � | married on | at City | County | State | |
| � | |||||
| 6.� | The said was the son or daughter of | ||||
| � | |||||
| � | born on | at City | County | State | |
| � | died on | at City | County | State | |
| � | and | his wife | |||
| � | born on | at City | County | State | |
| � | died on | at City | County | State | |
| � | married on | at City | County | State | |
| � | |||||
| 7.� | The said was the son or daughter of | ||||
| � | |||||
| � | born on | at City | County | State | |
| � | died on | at City | County | State | |
| � | and | his wife | |||
| � | born on | at City | County | State | |
| � | died on | at City | County | State | |
| � | married on | at City | County | State | |
| � | |||||
| 8.� | The said was the son or daughter of | ||||
| � | |||||
| � | born on | at City | County | State | |
| � | died on | at City | County | State | |
| � | and | his wife | |||
| � | born on | at City | County | State | |
| � | died on | at City | County | State | |
| � | married on | at City | County | State | |
| � | |||||
Signature of Applicant _________________________________ Date ___________
*I do not�give my consent to Belmont County Chapter, OGS and First Families of Belmont County to furnish information in this application to others.
*I do not�give my consent to Belmont County Chapter, OGS and/or First Families of Belmont County to publish the information contained in the Ancestor Chart (s) I have submitted.
I, ________________________________ do hearby swear or affirm that the statements set forth in this application, are true to the best of my knowledge.
Signature of Applicant _________________________________ Date ___________
| Mail completed application, ancestor chart(s) and $15.00 application fee (non-refundable) to: | |
| ���� | Belmont County Chapter OGS - First Families |
| ���� | PO Box 285 |
| ���� | Barnesville, OH 43713-0285 |
Return to Belmont County Chapter, OGS Home