1) Complete all pages of the application form If you already have an ancestral chart in a different format, a copy of that may be submitted.

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1 Czechoslovak Genealogical Society International Pioneer and Century Family Certificates How to apply 1) Complete all pages of the application form If you already have an ancestral chart in a different format, a copy of that may be submitted. After printing a form, please compare it with the screen to determine if all pages were printed. If portions of the forms have not been printed, the information can be written on separate sheets. Photocopies of forms may be made for multiple applications. 2) Include Copies of Official Records Ancestors may be individuals or couples married in Europe who then immigrated together. A couple who were married in Europe and who immigrated together may be named as ancestors on the same certificate, but to do so include copies of official records that document the presence of both husband and wife in North America at the same time. If you already have an ancestral chart in a different format, a copy of that may be submitted. It is customary to include maiden names of female ancestors in genealogical documents. The clearest method would probably be punctuated with parenthesis: Given Name (Maiden Name) Married Name Example: Maruska (Horák) Cormej. Note: The example shows that diacritical marks, such as the can be included. The applicant may, but is not required to, include information about ancestors preceding those who immigrated to North America. It is suggested that a photocopy of the completed application be retained for your records. Photocopy the official records that you will submit as proof of residency of ancestors on the North American continent. Photocopying Census Records: Be sure to photocopy page the headings which show the year, date, town/township, county, state, etc. If a census page cannot be reproduced on one sheet of paper, two sheets may be used with enough overlap to insure that the sheets are from the same page. Photocopies must be clear and legible. Photographs that might enhance the announcement of the award of the certificate that will be printed in the newsletter may be included. Do not submit original documents or photographs. 3) Write a check The fees for certificates are: $15.00 for members of CGSI $12.00 for certificates with the same ancestor and descent $20.00 for non-members of the Society. Checks should be made payable to the Czechoslovakia Genealogical Society International. The abbreviation CGSI may be used. Checks will not be deposited until the application has been evaluated and the awarding of a certificate has been approved. Send the completed application form, copies of official records, photographs and a check for the appropriate amount to: CGSI, P.O. Box 16225, St. Paul MN Directions for Application form.

2 Czechoslovak Genealogical Society International Pioneer and Century Family Certificates Application Form Please type or print clearly your name as you wish it to appear on the certificate. Use black ink. Name Address City State ZipCode Membership Number Telephone number Date of birth Place of birth If you are not married please write SINGLE on the line below. Name of spouse Date of spouse s birth Place of spouse s birth Date of marriage Place of marriage The name of your ancestor or ancestral couple who entered the North American Continent as you wish it to appear on the certificate Check the relationship of that ancestor to you: parent grandparent great grandparent great-great grandparent great-great great grandparent great-great great great grandparent Date of ancestor s entry into the North American continent Location of ancestor s entry into the North American continent Application form p. 1

3 Please record information about your immigrant ancestor(s). Some suggestions are: reasons for coming to North America, experiences with travel, occupations, the language, reactions to the new home, food, culture. Anything of interest would be appreciated. This information will be used to prepare an announcement of the award of a certificate. It is not necessary to write an extensive biography. Approximately one hundred words will be sufficient. Application form p. 2

4 Information about your descent from your immigrant ancestor. If the information is Not Available please enter N\A. If an ancestor is alive, please enter STILL LIVING on the lines for date and location of death. Name of parent Date of marriage Other North American residencies Spouse of parent Name of grand parent Place of birth Date of marriage Other North American residencies Spouse of grand parent Place of birth Name of great grand parent Date of marriage Other North American residencies Application form p. 3

5 Date of death Place of death Spouse of great grand parent _ Name of great great grand parent Place of birth Date of marriage Place of marriage Other North American residencies Spouse of great great grand parent _ Name of great great great grand parent Date of birth Place of birth Date of marriage Other North American residencies Date of death Place of death Spouse of great great great grand parent Date of birth Application form p. 4

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