Membership form

Association des familles Lauzon d'Amérique

69 blvd Ste-Anne

Ste-Anne des Plaines, Québec

J0N 1H0

I wish to join AFLA and I am enclosing the $25.00 membership fee.

I do not wish to join AFLA but I am sending the information that I possess

Please print and use maiden name for spouse
Name   Apartment  
Address   P.O . box  
City   Internet address  
Province/State   Tel. Home  
Postal/zip code   Tel. Work  
  ADDITIONAL INFORMATION   SPOUSE
Born/date/place   Name  
Number of children   Born/date/place  
Occupation   Death/date/place  
Marriage/date   Father's name  
Marriage/place   Mother's name  
  FATHER   MOTHER
Name   Name  
Born/date/place   Born/date/place  
Death/date/place   Death/date/place  
Marriage/date   Father's name  
Marriage/place   Mother's name  
  GRANDFATHER   GRANDMOTHER
Name   Name  
Born/date/place   Born/date/place  
Death/date/place   Death/date/place  
Marriage/date   Father's name  
Marriage/place   Mother's name  
  GREAT-GRANDFATHER   GREAT-GRANDMOTHER
Name   Name  
Born/date/place   Born/date/place  
Death/date/place   Death/date/place  
Marriage/date   Father's name  
Marriage/place   Mother's name  
  CHILDREN   SPOUSE
Name   Name  
Born/date/place   Born/date/place  
Death/date/place   Death/date/place  
Marriage/date   Father's name  
Marriage/place   Mother's name  
  CHILDREN   SPOUSE
Name   Name  
Born/date/place   Born/date/place  
Death/date/place   Death/date/place  
Marriage/date   Father's name  
Marriage/place   Mother's name  
  CHILDREN   SPOUSE
Name   Name  
Born/date/place   Born/date/place  
Death/date/place   Death/date/place  
Marriage/date   Father's name  
Marriage/place   Mother's name  
  BROTHER/SISTER   SPOUSE
Name   Name  
Born/date/place   Born/date/place  
Death/date/place   Death/date/place  
Marriage/date   Father's name  
Marriage/place   Mother's name  
  BROTHER/SISTER   SPOUSE
Name   Name  
Born/date/place   Born/date/place  
Death/date/place   Death/date/place  
Marriage/date   Father's name  
Marriage/place   Mother's name  
  BROTHER/SISTER   SPOUSE
Name   Name  
Born/date/place   Born/date/place  
Death/date/place   Death/date/place  
Marriage/date   Father's name  
Marriage/place   Mother's name  
  BROTHER/SISTER   SPOUSE
Name   Name  
Born/date/place   Born/date/place  
Death/date/place   Death/date/place  
Marriage/date   Father's name  
Marriage/place   Mother's name  
  BROTHER/SISTER   SPOUSE
Name   Name  
Born/date/place   Born/date/place  
Death/date/place   Death/date/place  
Marriage/date   Father's name  
Marriage/place   Mother's name  

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