Example #2 For a deceased relative

I__Fernand-Pierre Cyrenne________dauther/son of ___Henri Cyrenne____________ and grand dauther/grand son of __Armand Cyrenne________ authorize that the genealogical data that I am submitting be added to the Cyrenne and Syrenne family tree on the Web. (The names of your father and grand-father are needed to make connection between your data and that of the local computer).

I am submitting the following data: (i)

Personel genealogical data

Family name:__Cyrenne___________________________
First name:___Michel____________________________
Born on: ____16/03/1945_________________________
Born at:_____Trois-Rivières_____________________
Maried on: ____________________________________________
Maried at:_____________________________________________
Deceased on: __08/09/1969_______________________
Deceased at: ___Montréal________________________

Spouse's data (signature requised)

Family name:___________________________________________
First name:____________________________________________
Born on: ______________________________________________
Born at: ______________________________________________
Deceased on: _________________________________________
Deceased at: __________________________________________

Form for a deceased relative

If the form is for deceased relatives, do not forget to enter their deceased dates. Follow the date format (ii) for all dates entered. Enter your family relationship with the above relative (dauther, son, oncle, father etc...) __Brother______ (data can be E-mailed)

Please do not forget your signature,

your E-mail addresse: _xxx@yyy.com__________and

your postal addresse on the back of the form

Signed at __F.P Cyrenne on01/01/1997 Your signature _________________Spouse / Witness___Not required____

Mail to:
Cyrenne and Syrenne Genelogical Centre
37 Buckingham rd
Val des Monts (Perkins) Qc
J8N 7L3

(i) Except for first and family names, all other fields are optionnelles
(ii) Date format: DD/MM/YYYY or /MM/YYYY or /YYYY

.......