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2. Overview
   The Village of Montgomery’s Historic Preservation Commission is offering certificates to descendants of early Montgomery families. Centennial Family certificates will be awarded to descendants whose ancestor(s) settled in the Village of Montgomery 100 or more years ago. Pioneer Family certificates will be given to those who are direct descendants of early settlers who lived in Montgomery between 1835-1860.
4. Purpose
   The purpose of this program is to honor descendants of early Montgomery residents, and to collect information on these families and their descendants.
6. Eligibility
   Qualifications for the Centennial Family certificate are as follows:

   • The applicant must be a direct descendant of a person who lived in the Village of Montgomery 100 or more years ago (i.e., currently at any time up to and including the year 1910). Qualifications for the Pioneer Family certificate are as follows:

   • The applicant must be a direct descendant of a person who lived in the Village of Montgomery at any time between 1835 to 1860.

   Applicants need not be residents of the Village of Montgomery to apply.

   When determining whether or not your ancestor lived in Montgomery, please use the current geographic boundaries of the Village.

8. Certification
   Once the initial application is complete, the applicant may be asked for more information in order to verify that the ancestor lived in Montgomery during the stated time period. The applicant will be certified once all application materials have been received and proof is established.
10. Village of Montgomery Pioneer Ancestry Program Application
12. Please check which certificate you are applying for*

    1. Centennial certificate
    2. Pioneer certificate
14. First Name*
15. Last Name*
17. Address1*
19. Address2
21. City*
22. State*
23. Zip*
25. Email*
26. Phone*
28. First Name of Ancestor*
29. Last Name of Ancestor*
31. Ancestor Birth Date & Location*
32. Death Date & Location*
34. Ancestor’s spouse’s name
35. Spouse's birth date & location
37. Spouse death date & location
38. Dates these ancestors lived in Montgomery
40. Please describe how you are related to these people. If dates are unknown, simply use estimated dates, such as “about 1870.” *
42. I confirm that the above information is true and correct to the best of my knowledge. I understand that this information may be made available in the future to researchers and the general public.
43. Date & Time of Application*
    Date & Time of Application

    Date & Time of Application
Leave This Blank:


45. 1. Receive an email copy of this form.
46. Email address

    This field is not part of the form submission.

47. Submit

* indicates a required field