Whitfield-Murray Historical Society
Research Request Form
Non-Members fee for research minimum fee of $25 per request
Date __________________________________
Person Requesting Information _________________________________________________________________________________
Phone Number ____________________________________Email Address ______________________________________________
Address _______________________________________City, State, Zip code_____________________________________________
Please Fill in any information that you have on the person you are requesting information on
Request for person’s name ______________________________________________________________________________________
Maiden Name _____________________________________Nick Name _________________________________________________
Spouse’s Name ____________________________________Nick Name__________________________________________________
Parents Names (Father)_____________________________(Mother)_____________________________________________________
Birthdate _________________________________Place of Birth ________________________________________________________
City, County Born in ________________________________City, County Deceased In_______________________________________
What information are you requesting? __________________________________________________________________________________
_________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________
_________________________________________________________________________________________________________________
Please mail a check or call with your credit/debit card account number
Whitfield-Murray Historical Society
PO Box 6180
Dalton GA 30722-6180
Phone 706-278-0217
Hours Mon-Fri 10 am to 4 pm
Email address whitfieldmurrayhs@gmail.com
