Permission grant:

BCG needs your signed permission to share information from a five generation ancestor sheet. Please complete and return with your information.

I _____________________________ do/do not grant permission to Brooke County Genealogy to share my five generation ancestor chart.

Signed:_____________________________________

Date _______________________________________

YOUR address: ____________________________________

City _____________________________________________

State and ZIP _____________________________________

Phone (___) ____________________

E-Mail __________________________

URL ____________________________