Family Questionaire
Family Tree Questionaire
When filling out this questionnaire, please write the full name of each
person. EXAMPLE: Jonathan Henry Smith. (Maiden names) Please print or type, and answer all questions to the best of your ability. Ensure to include city and country for questions, which ask about births, deaths, burials, marriages, and divorces.
Your name: ______________________________________________
Date of birth: _________________ Birth Place: _______________________
Date of death: ________________ Death Place: ______________________
Place of burial: ____________________________
Your Spouses name (Maiden name): ______________________________
Date of birth: _________________ Birth place: _______________________
Date of death: ________________ Death place: ______________________
Place of burial: ____________________________
Date of marriage: ______________ Marriage location: __________________
Date of divorce: _______________ Divorce location: ___________________
List names of all children oldest to youngest, date, and place of birth.
If death occurred, indicate date, and place of death. If child was adopted list date of adoption, and from what adoption agency, orphanage, or hospital.
1. ____________________________________________________________
2. ____________________________________________________________
3. ____________________________________________________________
4. ____________________________________________________________
5. ____________________________________________________________
6. ____________________________________________________________
List additional children on separate sheet of paper.
If you or your spouse is in the following line of family (ies), please answer the following questions. Please indicate whose parents they are: ____________________________________________________________
First family name:______________________________________________
Second family name:____________________________________________
Third family name:______________________________________________
Fourth family name:_____________________________________________
Name of father: ________________________________________________
Date of birth: ____________________ birth place: _____________________
Date of death: ___________________ death place: ____________________
Place of burial: ____________________________
If this person immigrated here, list date of immigration, name of ship, and port of entry ___________________________________________________
____________________________________________________________
____________________________________________________________
Name of mother (Maiden name): __________________________________
Date of birth: ____________________ birth place: _____________________
Date of death: ___________________ death place: ____________________
Place of burial: ____________________________
If this person immigrated here, list date of immigration, name of ship, and port of entry: __________________________________________________
____________________________________________________________
____________________________________________________________
Date of marriage: ______________ Marriage location: _________________
Date of divorce: _______________ Divorce location: __________________
List all of your brothers and sisters, and dates of birth (if known) for easier tie-ins:
1.___________________________________________________________
2.___________________________________________________________
3.___________________________________________________________
4.___________________________________________________________
5.___________________________________________________________
6.___________________________________________________________
7.___________________________________________________________
8.___________________________________________________________
9.___________________________________________________________
10.__________________________________________________________
Any additional siblings please list on a separate sheet of paper.
If you have any additional information about our family, such as military history, immigration dates, places and ship names; please mail it to me.
All information is welcomed. Thank you for your time and cooperation with our family history. If you could please copy this and pass it around so we can as many family members updated as possible...
Please return questionaire to address below.
Janet Blitch
PO Box 7001
Warner Robins
Ga, 31095
BlitchFamily@gmail.com