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: |
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______________________________________________ ______________________________________________ |