Membership Form Part 2 – Demers Families Association

Member's First and Family Names *

Member number if known

City and Postal Code (for easy identification) *

E-mail *

Telephone

Family name and surname(s) of my Father

Family name and surname(s) of my Mother

Date and place of their mariage

Family name and surname(s) of my Spouse's Father

Family name and surname(s) of my Spouse's Mother

Date and place of their mariage

Family name and surname(s) of my Grandfather

Family name and surname(s) of my Grandmother

Date and place of their mariage

Family name and surname(s) of my Spouse's Grandfather

Family name and surname(s) of my Spouse's Grandmother

Date and place of their mariage

Family name and surname(s) of my Great-grand-father

Family name and surname(s) of my Great-grand-mother

Date and place of their mariage

Family name and surname(s) of my Spouse's Great-grand-father

Family name and surname(s) of my Spouse's Great-grand-mother

Date and place of their mariage

Family name and Surname(s) of my Great-great-grand-father

Prénom

Nom

Family name and Surname(s) of my Great-great-grand-mother

Prénom

Nom

Date and place of their mariage

Family name and Surname(s) of my Spouse's Great-great-grand-father

Prénom

Nom

Family name and Surname(s) of my Spouse's Great-great-grand-mother (copier)

Prénom

Nom

Date and place of their mariage