New membership ___ or Renewal ___

Personal information

Name:_________________________________________________________________________

Date of birth: ___________________________ Location: ____________________________

Address: _______________________________ City or town: _________________________

Postal Code: _______________ Res. _______________ E-mail: ______________

Profession: ________________________ Retired: ____________________

For your first membership to the association the fee is 30$ and with this you receive your direct lineage
and a journal . After that the annual fee is 25$ for renewal. We also have a life membership at a cost of  250$.

* US members pay in US dollars.

Please mail a check or money-order to:
ASSOCIATION DES FAMILLES LAVOIE : C.P. 10090, Succ.Sainte-Foy, Québec, Canada, G1V 4C6

Genealogy information;

Name of spouse: ___________________________________________________________________________

Date of birth: ______________________________ Location: _____________________________________

Date of marriage: __________________________ Location:______________________________________

Father of spouse: __________________________________________________________________________

Mother of spouse: _________________________________________________________________________

My father: ________________________________________________________________________________

His date of birth: ___________________________ Location: _____________________________________

Death: ____________________________________ Location: ______________________________________

My mother: _______________________________________________________________________________

Her date of birth: _________________________ Location: _______________________________________

Death: ___________________________________ Location: ______________________________________

Their marriage date: _____________________ Location: ______________________________________

My grandfather: _________________________________________________________________________

Grandmother’s name at birth: ____________________________________________________________

Their marriage date: _____________________ Location: ______________________________________

Please, list your siblings, uncles and aunts, date of birth, marriages, etc. if any, on an attached sheet.

Signature: ________________________ Date:__________________________