BENDIGO REGIONAL GENEALOGICAL SOCIETYINC.
80022731P
Research Request Form

Please print this form and, after completing it, send it with your searchfee and a stamped self addressed envelope to:

BENDIGO REGIONAL GENEALOGICAL SOCIETY INC.
PO BOX 1049,
BENDIGO, 3552.

Please help us help you by PRINTING neatly.

When you forward your request to us we would be grateful if you wouldalso include as much supporting information as you can.  This willprevent us from simply sending you information which you already have.
 

Your Full Name________________________________________Date______________

Postal Address___________________________________________________________

_____________________________________________________PostCode__________

E-mail                            __________________

Brief Summary of Request - Please attach any additional documents thatmay assist us:
 
 
 
 
 
 
 
 
 
 
 

Your Signature_________________________  Date __/__/_____

If you are happy for us to pass you name on to other researchers whoare interested in the same family or research topic, please indicate.

Share Information?  Yes / No    (Please circleone)

Search Fee
Within Australia: $20.00 per hour.  Plus the cost of photocopies and film hire.


OFFICE USE:

Date Received:             __/__/_____

Amount Received:        $_____.__                  SAE?  Y / N

Information Dispatched:  __/__/_____

Research Coordinator:  ________________________________