DEFIANCE COUNTY CENTENNIAL FAMILY REGISTRATION FORM

The Defiance County Genealogical Society would like to honor those who have proof by documentation that their family came into Defiance County one hundred years ago or more by recognizing them with the designation of Defiance County Centennial Family. A certificate will be presented to those families who qualify and the family will be registered with the society for future researchers.

Requirements for the Defiance County Centennial Family Registration

1. You must fill out the application completely and accurately.
2. You must be a member of the Defiance County Genealogy Society.
3. You must explain how you are connected with this family by blood, marriage, or research you have done on this unrelated family.
4. You must have a document that the family was in Defiance County 100 years prior to the present date.

If you wish to provide a five generation chart and a family group sheet on the family that is being  registered, this information will be used for other researchers that are trying to locate the family that you have registered so that you may make a connection. If you do not allow us to publish your 5 gen. Chart or  family group sheet please allow us to publish your name and address and the name you have registered. 
 
No application will be returned except for necessary clarification.
 
All information will become property of the Defiance County Chapter of the Ohio Genealogy Society. The information may be published in any of the society’s publications, website or in a file at the Defiance Public Library.
 
Please only register one person or family per form by sending the necessary documentation
 
Information about you: 
 
Your Name ________________________________________________________________________________
 
Address ___________________________________________
 
City ________________________________ State __________ 9 Digit Zip Code _____________ - _________
 
Telephone Number (______) ___________ - __________  E-mail address ____________________@________
 
Family (first and last name) that you are registering ________________________________________________
 
How are you connected to the family? Related or other please explain: _________________________________
 
__________________________________________________________________________________________

I give my permission to publish my family group sheet and my five generation chart (yes / no) 
I will allow you to publish my name and address with the name I have registered ( yes / no) 
 
Please sign your name _________________________________  date __________________
 
Do not write here Committee Chair only   Accepted by ______________________________ Date __________