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

 

 

GISBORNE & MT. MACEDON DISTRICTS HISTORICAL SOCIETY INC.
ABN 82 893 878 458 Inc. No. A 0027147L
 

RESEARCH FORM

I  would like The Gisborne & Mount Macedon Districts Historical Society to research on my behalf.

RESEARCHER’S NAME:
ADDRESS:
 
 
PHONE: POSTCODE:
*E-MAIL: *WEBSITE:
SURNAMES OR TOPICS TO BE RESEARCHED:
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3 4
   
   
   
YOUR RELATIONSHIP OR INTEREST:
 
 
 
 
SIGNATURE OF RESEARCHER:

 

 DATE:

 

 * When applicable