Once you have printed out your Haller's Army search results and highlighted the name(s) of interest, complete this form and mail it to the address below.

Name requested (Surname, given)	Form type(s) requested*	Cost*

*Form A is the Application ($5/$8)
Form C is the acceptance into the Army ($5/$8)
Form L usually contains forms A, B, and C ($7/$10)
Please note that if you order more than one form, you may get duplicate information.

Include a check for a $5 (U.S.) donation (PGSA member) or $8 (U.S.) (non-member) per highlighted name for Forms A, B, or C; for the usually comprehensive Form L, the costs are $7 for members and $10 for non-members. The donation is used for the costs of supplies, equipment, and materials. If you are not a member, please consider joining the Polish Genealogical Society of America, and taking immediate advantage of membership benefits.

Are you a PGSA Member? Yes____ No______ If yes, Membership #_____________

Amount submitted: $ _________ Please make check out to PGSA.

Name__________________________________________________________

Address ________________________________________________________

____________________________________________________________________

email address ____________________________

For copies of English translations of the forms, click on - Form A | Form C

Please note that requests without the Haller's Army search results will be returned.

Send your request with a Stamped Self Addressed Envelope to:

PGSA
984 N. Milwaukee Avenue
Chicago, IL 60642-4101