Research Fee
Members-$40
Non-Members-$50
Please include your payment when mailing this form.

Cumberland County Historical Society
21 North Pitt Street
Carlisle, PA 17013
http://www.historicalsociety.com

DATE : ___________________________________
 

SURNAME OF FAMILY BEING SEARCHED : ___________________________________________________

______________________________________________________________________________________________

______________________________________________________________________________________________
 

BIRTH & DEATH DATES OF INDIVIDUALS : _________________________________________________________

______________________________________________________________________________________________

______________________________________________________________________________________________

______________________________________________________________________________________________
 

FAMILY'S CONNECTION TO CUMBERLAND COUNTY, PA : _______________________________________________

______________________________________________________________________________________________

______________________________________________________________________________________________

______________________________________________________________________________________________

______________________________________________________________________________________________
 

SPECIFIC INFORMATION NEEDED : ________________________________________________________________

______________________________________________________________________________________________

______________________________________________________________________________________________

______________________________________________________________________________________________
 

COMMENTS : ___________________________________________________________________________________

______________________________________________________________________________________________

______________________________________________________________________________________________

______________________________________________________________________________________________
 

NAME : _________________________________________

ADDRESS : ____________________________________________________________________________________

______________________________________________________________________________________________

E-MAIL ADDRESS : _________________________________________