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Do not write in above section.  For OBCGS/FFOB use only.

First Families of Old Buncombe

A Pioneer Heritage Organization of Old Buncombe County

Membership & Certificate Application

Instructions:  This application is in 2 parts: (1)This application form*, (2) the Line of Descent/Proof Document Form (click here)  Complete both parts.  BOTH parts must be completed and submitted.  Please type or print legibly all information.  Sign and date the application and consent form.  (Applications without signature will NOT be processed.)  Send ALL of the above along with photocopies (NO originals, please!!) of your documentation/ proofs and a check or money order in the amount of $25.00 to:

First Families of Old Buncombe

c/o Old Buncombe County Genealogical Society

PO Box 2122

A.  Applicant’s name (as you wish it to appear on the certificate):

     _______________________________________________________________________

     Street Address:

     ________________________________________________________________________

     City, State, Zip:

B.  Ancestor’s Name as it is to appear on the certificate (name of qualifying ancestor who was in

     Buncombe County prior to December 31, 1800):

      _______________________________________________________________________

First date proven to be in Buncombe County (REQUIRED):

      _______________________________________________________________________

      Birth (date & place):

      ______________________________________________________________________

      Baptism (date & place):

      ______________________________________________________________________

      Married (date, place, by whom):

      ______________________________________________________________________

      Death (date & place):

      ______________________________________________________________________

      Burial (date & place):

      ______________________________________________________________________

      Spouse (maiden name if known):

      ______________________________________________________________________

      Spouse Birth (date & place):

     ______________________________________________________________________

      Spouse Death (date & place):

      ______________________________________________________________________

      Where in Old Buncombe County did your ancestor live, if known?

      ______________________________________________________________________

  *Please give all requested information known about your ancestor.  If the information in a specific field above is not known (for example: birth date), please so indicate.  Your application will not be rejected for lack of information in any above field with the exception of the first date proven to be in Old Buncombe County field, but including any known information in the other fields will expedite your application.

I am applying from membership in First Families of Old Buncombe and am submitting the enclosed information for that purpose.  I understand and agree that all material submitted to OBCGS with this application becomes the property of OBCGS and will not be returned.  I further grant permission for this material to be published or otherwise disseminated, as OBCGS deems appropriate.  I have read & understand the accompanying information on FFOB in ALOB, the website, or the information sheets.

Signed ____________________________________________ Date _______________

I do ____ do not ____ wish my address ____, telephone number ____ and/or e-mail address ____ to be shared with other researchers of the same surname and/or qualifying ancestor.

Signed ___________________________________________ Date ________________

E-mail Address_____________________________ Telephone____________________

NOTE: applications lacking ANY of the following will not be processed: Signed application, Line of Descent /Proof document Form, $25 check or money order