Print & send to:                    Gisborne & Mount Macedon Districts Historical Society Inc.

                                            P.O.Box 113 Mount Macedon
                                            Victoria, 3441, Australia

 

or print & fax to:                   03   5428 1534

 

or copy, paste & email to:   history@gisbornemountmacedon.org.au

 

The Gisborne & Mount Macedon Districts Historical Society invites all researchers to have their name and the names they are researching, added to our Researchers’ Interest List, so that others researching the same name or topic, can be put in touch if required.

 

Please fill in this form if you would like to be included.

 

GISBORNE & MOUNT MACEDON DISTRICTS HISTORICAL SOCIETY INC.

ABN 82 893 878 458       Inc. No. A 0027147L

 

RESEARCHERS'  INTERESTS  SUBMISSION FORM

 

RESEARCHER’S NAME:
ADDRESS:
 
 
PHONE: POSTCODE:
*E-MAIL: *WEBSITE:
I AM INTERESTED IN FAMILIES OF THE FOLLOWING SURNAMES:
1 2
   
3 4
   

I AM INTERESTED IN THE HISTORY OF:

[ localities, buildings, organizations, industries, etc.]

 
 
 
 
SIGNATURE:

 

 DATE:

 
 

* When applicable