Genealogy Applicant Information Sheet

Your Name______________________________________________

 Spouse____________________

Address________________________________ City_______________ St_________ Zip_________

Phone: H:_(____)__________________ W: _(____)___________________ Best to Call H or W

E-mail:______________________________________ (preferred for communication)

Please give us as much information as you can about the ancestor you wish us to research. Give approximations 1850’s, 1790’s, etc. Be as specific as possible regarding locations, known or assumed, of cities, counties, states or countries.

Who is the primary person/ancestory we are to research?__________________________________
(with possible spelling variations)

Give us a specific research goal concerning this ancestor___________________________________
Example: Find his parents; where did he die?; Who are his wife and children?


Date of Ancestor’s birth:_____________________________________________ best guess.

Where was he/she born? ______________________________________________________________

Date & location of Ancestor’s death_______________________. Where Buried?_______________

Do you know who Ancestor’s spouse was? ______________________
Marriage Date? ___________________________
Children? __________________________________________________________________________

Any other information about them? _____________________________________________________

(Ancestor’s religion? Occupation?)

Do you know who the ancestor’s parents were? ___________________________________________

Any brothers or sisters? ______________________________________________________________

Other relatives?_________________________

Do you know where the Ancestor’s family came from or where they lived prior to where they last lived? _____________________________________________________________________________


Please add anything else you know about your ancestor, i.e. birth date & place, occupation, death date & place, marriage date & place ___________________________________________________


What records have you searched for this Ancestor and what have you found? __________________________________________________________________________________

__________________________________________________________________________________

Type of research you would like us to perform? ____________________ Basic, Moderate, etc.

(See page on Research Fees)

Enclosed is my retainer fee in the amount of $_______ for the requested research service. Please pay by check or money order. If desired, please call us at (865) 397-6844 and we can take your Visa or Mastercard order over the phone.

Send completed form and retainer fee to: Clay Patterson, CG^SM, P.O. Box 397, Dandridge, Tennessee 37725

Please use backside if needed. For those who have significant information of this ancestor or other generations, family charts are attached to this form for your use. Please include copies of any information on this ancestor and his/her relatives. The more information we start with, the more productive we can be in finding new material instead of duplication of what you already have.

Please see fee schedule for categories and minimum retainer fees.