APPLICATION FOR MEMBERSHIP

The Holland Society of New York

DATE _______________________  

Full Name of Applicant_________________________________________________________________
(PRINT OR TYPEWRITE NAME IN FULL WITHOUT ABBREVIATIONS)
Signature of Applicant__________________________________________________________________
Residence____________________________________________________________________________
Telephone_________________________________________E-mail______________________________
Occupation____________________________________________________________________________
Office ________________________________________________________________________________
Address to which notices should be sent____________________________________________________
______________________________________________________________________________________

Proposed by ___________________________________________________________________________
(SIGNATURE OF PROPOSER)
Address ______________________________________________________________________________
Seconded by___________________________________________________________________________
(SIGNATURE OF SECONDER)
Address ______________________________________________________________________________

The proposer will kindly say how long he has been acquainted with the applicant and
what personal knowledge he has of his character and reputation in the community.

______________________________________________________________________________________

______________________________________________________________________________________

______________________________________________________________________________________

______________________________________________________________________________________

 

DESCENT MUST BE IN DIRECT MALE LINE ONLY

This application must be filled in to qualify for membership in The Holland ‘Society of New York. Genealogical references are esential.
 
I claim descent from __________________________________________________________
who came to this country from _____________________________in the year 16_____) through the following line on my father’s side.
1. I was born _______________________________at _______________________________
I am the son born to
 
2.______________________________________________ born at _____________________
on _____________________died at ________________________on___________________
and (wife’s name) ______________________________________Marriage Date: _________
References_________________________________________________________________
___________________________________________________________________________
He was the son born to
3.______________________________________________ born at _____________________
on _____________________died at ________________________on___________________
and (wife’s name) ______________________________________Marriage Date: _________
References_________________________________________________________________
___________________________________________________________________________
He was the son born to
4.______________________________________________ born at _____________________
on _____________________died at ________________________on___________________
and (wife’s name) ______________________________________Marriage Date: _________
References_________________________________________________________________
___________________________________________________________________________
He was the son born to
5.______________________________________________ born at _____________________
on _____________________died at ________________________on___________________
and (wife’s name) ______________________________________Marriage Date: _________
References_________________________________________________________________
___________________________________________________________________________
He was the son born to
6.______________________________________________ born at _____________________
on _____________________died at ________________________on___________________
and (wife’s name) ______________________________________Marriage Date: _________
References_________________________________________________________________
___________________________________________________________________________
He was the son born to
7.______________________________________________ born at _____________________
on _____________________died at ________________________on___________________
and (wife’s name) ______________________________________Marriage Date: _________
References_________________________________________________________________
___________________________________________________________________________
He was the son born to
8.______________________________________________ born at _____________________
on _____________________died at ________________________on___________________
and (wife’s name) ______________________________________Marriage Date: _________
References_________________________________________________________________
___________________________________________________________________________
He was the son born to
9.______________________________________________ born at _____________________
on _____________________died at ________________________on___________________
and (wife’s name) ______________________________________Marriage Date: _________
References_________________________________________________________________
___________________________________________________________________________
He was the son born to
10.______________________________________________ born at _____________________
on _____________________died at ________________________on___________________
and (wife’s name) ______________________________________Marriage Date: _________
References_________________________________________________________________
___________________________________________________________________________
He was the son born to
11.______________________________________________ born at _____________________
on _____________________died at ________________________on___________________
and (wife’s name) ______________________________________Marriage Date: _________
References_________________________________________________________________
___________________________________________________________________________
He was the son born to
12.______________________________________________ born at _____________________
on _____________________died at ________________________on___________________
and (wife’s name) ______________________________________Marriage Date: _________
References_________________________________________________________________
___________________________________________________________________________
He was the son born to
13.______________________________________________ born at _____________________
on _____________________died at ________________________on___________________
and (wife’s name) ______________________________________Marriage Date: _________
References_________________________________________________________________
___________________________________________________________________________
He was the son born to
14.______________________________________________ born at _____________________
on _____________________died at ________________________on___________________
and (wife’s name) ______________________________________Marriage Date: _________
References_________________________________________________________________
___________________________________________________________________________
 

APPLICANT’S WIFE AND CHILDREN

 

Full maiden name of applicant’s wife _______________________________________________________
Place and date of her birth ________________________________________________________________
Daughter of  __________________________________ and _____________________________________
Place and date of her marriage _____________________________________________________________
Children:
Name ___________________________________________________Birthdate_____________________ Name ___________________________________________________Birthdate_____________________ Name ___________________________________________________Birthdate_____________________
If the applicant is related to a present or former member of the Society with the same family name, please complete the following:
_________________________________________________________a (former) member of The Holland Society of New York, is (was) my____________________ our latest common ancestor being _______________________________________________________________________________________

INFORMATION CONCERNING REFERENCES

 

Recognized references include:
1. Church records (baptisms, marriages, church membership rolls).
2. Municipal, county and state records (birth, marriage and death certificates).
3. Published record sources in periodicals such as The New York Genealogical & Biographical Record, The Genealogical Magazine of New Jersey, The Dutch Settlers Society Yearbooks, The Holland Society of New York Yearbooks; also state and county historical and genealogical publications.

4. Family genealogies in published and manuscript form.

5 Family Bible and personal records (dates of births, marriages and deaths).

6. Other record sources (Census records, wills, tax rolls, Federal pension applications, etc.).
Date application received_________________________________________________________________
Application examined and approved by Committee on Genealogy
________________________
Chairman
________________________
Date

Date of election to Society by Board of Trustees______________________________________________

_____________________________________________________________________________________