CONFEDERATE ANCESTOR QUESTIONNAIRE

There is a $10.00 fee. I am, for now, using the honor system. If you feel that I have helped, please send $10.00 cash or check (made out to me) to: Lora M. Koch 9112 Castle Point Drive Glen Allen, Virginia 23060 Please complete as much of this form as you can but you must at least fill out the First Name, and Last Name of YOUR ANCESTOR. You may leave the rest blank. Don't omit your email address. I cannot communicate with you without one! I will try to respond to this request promptly but I cannot guarantee how fast my response will be, because of the number of requests, etc. Please send any comments about my service or questions about this form to me via email. Lora Koch

* Required Fields


* ENTER YOUR NAME:

* ENTER YOUR EMAIL ADDRESS:




YOUR ANCESTOR'S NAME:
* FIRST

MIDDLE

* LAST



YOUR ANCESTOR'S BIRTH INFORMATION:
DATE OF BIRTH

LOCATION



YOUR ANCESTOR'S ENLISTMENT INFORMATION:
DATE

LOCATION



YOUR ANCESTOR'S MILITARY SERVICE: (UNIT NO. DIVISION, CORPS, etc.)


YOUR ANCESTOR'S SPOUSE'S NAME:
FIRST

MIDDLE

LAST



YOUR ANCESTOR'S DEATH INFORMATION:
DATE OF DEATH

LOCATION




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COMMENTS OR ADDITIONAL INFORMATION:





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© Copyright 2002-2008 by L. Koch All Rights Reserved.