Use this form to DONATE information if you do NOT expect a reply. To request a search, use the form at http://www.judywebster.gil.com.au/swq-searchform.
PRINT this form South-West Qld Project: Data Donation Form
Use this form to DONATE information about people in Paroo/Bulloo Shires only (Cunnamulla, Eulo, Wyandra, Hungerford, Wooroorooka, Thargomindah, Nocundra). Write extra details on the back of the page. Fill in a separate form for each child of this couple who also lived in the area as an adult. Post forms to: Judy Webster, PO Box 5043, Algester QLD 4115, Australia.
Person's Name: __________________________________________________________
Father's Name:______________________________ Birthplace:___________________
Mother's Name:_____________________________ Birthplace:___________________
Date of Birth:__________________ Place:_____________________________________
Date Married:_________________ Place:_____________________________________
Port of Arrival:______________ Date:____________ Ship:________________________
Came to SWQ (when)___________ from (where)_________________________________
Left SWQ (when)____________ and moved to___________________________________
Died/Buried: ___________________Place: _____________________________________
Occupations:______________________________________________________________
Places of residence in SWQ:_________________________________________________
Other marriages___________________________________________________________
Spouse's Name (maiden surname if female):_____________________________________
Father's Name:_______________________________ Birthplace:____________________
Mother's Name:______________________________ Birthplace:____________________
Date of Birth:__________________ Place:______________________________________
Date Married:__________________ Place:_____________________________________
Port of Arrival:_______________ Date:____________ Ship:________________________
Came to SWQ (when)___________ from (where)_________________________________
Left SWQ (when)____________ and moved to___________________________________
Died/Buried:____________________Place:______________________________________
Occupations:______________________________________________________________
Places of residence in SWQ:_________________________________________________
Other marriages___________________________________________________________
Children:
1 __________________________________b._____d._____Spouse:_______________
2 __________________________________b._____d._____Spouse: ______________
3 __________________________________b._____d._____Spouse:_______________
4 __________________________________b._____d._____Spouse:_______________
5 __________________________________b._____d._____Spouse:_______________
6 __________________________________b._____d._____Spouse:_______________
7 __________________________________b._____d._____Spouse:_______________
8___________________________________b._____d._____Spouse:_______________
9___________________________________b._____d._____Spouse:_______________
10__________________________________b._____d._____Spouse:_______________
I give permission for this information to be added to the SWQ Local History Collection.
Name: _____________________________________ Signature: ____________________________
Address: __________________________________________________________________
______________________________________________________ Date: ___________________
E-mail(s):______________________________________________________________________
Post the form to the address above. If you want a reply, do NOT use this form - go to http://www.judywebster.gil.com.au/swq-searchform.