Surname Request Form

Please print and complete this form, and mail it to the address below. A search using the following two sources will be done for each surname:

  • The first is William Hoffman’s Polish Surname: Origins and Meanings (2d ed.). If your name appears, you will get information on the derivation and see related names, as available. This book may also be purchased from PGSA if you are researching a lot of surnames.
  • The second is Kazimierz Rymut’s Dictionary of Surnames in Current Use in Poland(CD). It lists all the surnames in Poland at the time of the 2000 census, and the number of people with that surname, plus a code indicating where those people lived. This can be helpful in identifying places where your surname clusters today—and thus where your ancestors came from.

Include a check for a $5 (U.S.) donation (PGSA member) or $8 (U.S.) (non-member) per surname. 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.

SurnameSurname Variation(s)Location Clues

Are you a PGSA Member? Yes____ No______ If yes, membership #________

Amount submitted: $ ______ Please make check out to PGSA.

Email Address:_____________________________________


Address _____________________________________________________

The key to the geographic codes will be sent to you by email.

Please send your order (completed form with check) with a Stamped Self-Addressed Envelope to:

984 N. Milwaukee Avenue
Chicago, IL 60642-4101