LOOKUP REQUEST FORM

Note: for obituary orders, please use the

Obituary Order Form.

PAGE ONE OF TWO PAGES

BLAIR COUNTY GENEALOGICAL SOCIETY

ROLLER-HOJETH MEMORIAL LIBRARY

431 SCOTCH VALLEY ROAD

HOLLIDAYSBURG, PA 16648

Please type or print legibly.

NAME: ___________________________________________________________

ADDRESS: _______________________________________________________

CITY/STATE/ZIP: __________________________________________________

DATE: ___________________________________________________________

EMAIL ADDRESS: _________________________________________________

Please check the following BCGS publications or library resources:

1. _______________________________________________________________

2. _______________________________________________________________

3. _______________________________________________________________

4. _______________________________________________________________

for the following information I wish to find:

_________________________________________________________________

_________________________________________________________________

_________________________________________________________________

_________________________________________________________________

_________________________________________________________________

PLEASE GO TO PAGE TWO, PRINT AND FILL OUT THE CHART AND

INCLUDE IT WITH YOUR REQUEST.