Preliminary Declaration

LOS CALIFORNIANOS

Name: ______________________________________________________ Date: ______________

Maiden name, if applicable: ______________________________________________________

Birth Date: _________________Birthplace: ___________________________________________
dd mon yyyy

name (parent, gparent, ggparent, . . . )	birth/ baptism (dates and places)	MARR. (date and place)	death/ burial (dates and places)	spouse (full name)	spouse (other information: dates and places)

at this time, please do not send any documents other than the forms we provide on the web site or those you may have from the membership secretary.

Click here to return to Instructions (15 July 2002)