Please print and complete this form and mail it to the address listed below with a self-addressed stamped envelope. We ask that you limit your requests to three names per week, as this will enable the volunteers to fill requests in a timely manner.

A search will be done for each surname using several sources, such as:

• Slownik Geograficzny (CD)*
• Spis Miejscowosci Polskiej Rzeczypospolitej
• One or more gazetteers, as available for the area
• One or more atlases

It is VERY important that your request includes the province or partition (Galicia, Prussia, or Russia), and any other clues that may help us identify the right place, as there are many towns in Poland with the same name.

A location search is very time consuming. Therefore we are asking for an $8 donation from PGSA members and $12 from non-members per town/search. Donations are used for copies, equipment maintenance, general overhead, and supplies. If you are not a member, please consider joining for only $20 per year and taking advantage of membership benefits.

If you are researching a lot of towns, it may be practical for you to purchase Slownik Geograficzny from PGSA.

*A guide to translating Slownik Geograficzny can be found at www.pgsa.org/towns/slownik_eng.htm

Are you a PGSA Member? Yes______ No______ Membership #___________

Name _______________________________________________________

Address _____________________________________________________

________________________________________________________________

Email Address _____________________________________

Please send your request with a Stamped Self Addressed Envelope to:

PGSA
984 N. Milwaukee Avenue
Chicago, IL 60622-4101