Expulsion from Grand Pré
by Robert Dafford
     
   

Last updated: 2008-03-30

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 The Bourque Group

 

 

 
 
  REGISTRATION FORM
  PLEASE COMPLETE, PRINT AND SEND BY MAIL WITH YOUR PAYMENT
  Personal information     Member number:
 
First name
Last name
 
Street
Apt.
 
City
Province/State
 
Zip/Postal Code
Country
 
Telephone
 
E-Mail
  REGULAR MEMBER 1 YEAR 20$
BENEFACTOR 1 YEAR 30$		 REGULAR MEMBER 3 YEARS 50$
LIFETIME MEMBER 300$
  Amount
  Cheque to the order of : LES DESCENDANTS D'ANTOINE BOURG INC.

Genealogy information
    A) Spouse's name
    Marriage: date and place
    B) Your father's name
    Your mother's name
    Marriage: date and place
    C) Your grandfather's name
    Your grandmother's name
    Marriage: date and place
 
If you want to send us further information, do it on separate sheets. Don't forget your children and your grand children.
  I ACCEPT THAT MY NAME AND ADDRESS BE PUBLISHED IN THE BULLETIN.(CIRCLE) ......YES.........NO
  Please mail to the following address :
LES DESCENDANTS D'ANTOINE BOURG INC.
C.P. 10090
Succ. Sainte-Foy, (QUÉBEC)
CANADA G1V 4C6
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