Obituary Request Form

Once you have printed out your obituary search results and highlighted the name(s) of interest, complete this form and mail it to the address below.

Include a check for a $5 (U.S.) donation (PGSA member) or $8 (U.S.) (non-member) per highlighted name. The donation is used for the costs of supplies, equipment, and materials. If you are not a member, please consider joining the Polish Genealogical Society of America, and taking immediate advantage of membership benefits.

Are you a PGSA Member? Yes____ Membership #________ No______

Amount submitted: $ _______ Make check out to the PGSA.

Email Address:_____________________________________

Name_______________________________________________________

Address _____________________________________________________

_________________________________________________________________

Please note: Requests without copies of the Obituary search results will be returned.

For translation help, click on the Obituary Translation Guide.

Please send your order (completed form, search results, and check) with with a Stamped Self Addressed Envelope to:

PGSA
984 N. Milwaukee Avenue
Chicago, IL 60642-4101