Please make your check out to the Eaton County Genealogical Society. The fee of $7.50 and $2.50 for additional certificates should be included with the Eaton County Pioneer Certificate Project application and forms and mailed to Eaton County Genealogical Society at 100 W. Lawrence Ave., P.O. Box 337, Charlotte, MI 48813-0337.

Print or Type all information in black ink, --Surnames should be in Capital Letters.

1. The Applicant's Name (This is who the certificate will be mailed to):

_____________________________________________Phone:___________________________

Street Address of Applicant_______________________________________________________

City, Town, and State, Zip.________________________________________________________

E-Mail________________________________________________________________________

Researcher's Name if different than Applicant_________________________________________

2. Name of the ANCESTOR:

______________________________________________________________________________

(Name of qualifying ancestor who was in Eaton County, Michigan before 1910, as it will appear on the Certificate)

Birth Date________________ Birth Place (city, state, P.O.Box) ___________________________

Baptism Date_____________Baptism Place ___________________________________________

Death Date______________ Death Place______________________________________________

Buried Date______________ Buried Place_____________________________________________

Married Date_____________ Married Place____________________________________________

Spouse__________________________________________________________________________

(Maiden name when applicable)

Spouse Birth Date____________ Spouse Birth Place(city, State, P.O.Box)

__________________________________

Spouse Death Date____________ Spouse Death Place__________________________________

3. Where in Eaton County did the Ancestor settle?

______________________________________________________________________________

(City, town, village, township, region)

4. Emigrated from_______________________________________________________________

(Township, County, State, Province/Country--if known)

5. Proof for above: _________________________________________________ Doc#_________

In addition, you are invited to submit further information about your pioneer family, including Biographies, (overview of the pioneer's family and life, origins, migrations and early life in Eaton County), Family Record Sheets, Land Records and Plat maps of each location lived, Newspaper Articles, etc. This does not prohibit you from publishing your own data if you should desire.

Appropriate Privacy Laws or other Publication Restrictions will be followed and adhered to.

The submitting applicant is responsible for the accuracy, truthfulness and completeness of this survey and application and its proofs and materials.

They have been reviewed by the EATON COUNTY GENEALOGICAL SOCIETY.