List: this is copied from the form I got from M.Bevins site which apparently no longer exists........you can make your own and have it ready in a folder....... Cynthia - -------------------------------------------------------------------------- - ---------------------------------- General Services Center Reference/Research Drawer 33 Monteplier, Vt 05366-7601 tel: 802-828-3286 fax: 802-828-3710 APPLICATION FOR SEARCH OF VERMONT BIRTH RECORD 1.please type or print all information clearly 2. enclose check, money order, or Visa/Master Charge card #. (make check payable to General Services" 3. mail to above address 4. you MUST enclose a self-addressed stamped evelope 5. price is $7.00 per person searched, per time period 6. check the time period to be searched below: 1760-1870______ 1781-1908_____ 1909-1941_____ 1942-1954_____ 1955-79_____ 1980_____ 1981____1982______ 1983_____1984_____ 1985_____ 1986______ - -------------------------------------------------------------------------- - ----------------------------------------------------- 1. Name of person at birth or adoption__________________________________ 2. Approximate date of birth_________________ 3, Vermont city or town of birth___________________ 4. Maiden name of mother_________________________________ 5, Name of Father________________________________ 6. your relationship to person being searched________________________ 7. any other pertinent information relating to person being searched________________________ 8. this document is needed for what purpose ___________________________ YOUR name_________________________ cash enclosed $_____________ Street________________________ check enclosed $______________ Town____________________ State_______ Money order________ Zip__________ Telephone____________ cash enclosed $___________ check enclosed $__________ money order enclosed $_______ mastercard/visa card number _______-________-________-__________ - -------------------------------------------------------------------------- - ------------------------------------------------------- Researched by:______________________ date:______________