West Winfield Academy, Herkimer County, New York, Lookup Request Form

Type from your keyboard on this screen then print the form OR print the form and fill it out by hand. No COD orders.

Your name:
Street address:
City, State/Province:
Zip/Postal Code:
Country:
E-Mail:

Print the Full Name of Ancestors you want looked up. (e.g. Smith, John)

     
USA ORDERS Shipped to a USA address. Cheques or International Money Orders in US Dollars. Do NOT send a postal money order with red on it. They can only be cashed in USA
Cost
Lookups $12.00 for each name

Choose one: Surface Mail Add $1.50

Send scan by email TOTAL DUE in American Dollars 		Amount Due
$

$


$

CANADIAN ORDERS Shipped to a Canadian address via surface mail. Cheques in Canadian Dollars
Cost
Lookups $15.00 for each name

Choose one: Surface Mail Add $1.50

Send scan by email

TOTAL DUE in Canadian Dollars 		Amount Due
$

$


$

Other Countries please contact Brian for price details.

Please mail form with your cheque or International money order, payable to Brian Massey to:

Brian Massey
Box 341
Port McNicoll ON L0K 1R0
Canada 		Email:Brian
Fax: 1 (705) 534-2816

Thank you for your order! Please allow 4 - 6 weeks for delivery. All cheques are held for 14 business days to clear bank. Home