Farm Name: 

Birth Date:    Death Date: 

                    (click in boxes above and enter appropriate dates)

NAME IN AMERICA

First Name:      Last Name: 

SPOUSE

First Name:      Surname: 

Farm name at marriage: 

Birth Date:    Death Date: 

                    (click in boxes above and enter appropriate dates)

CHILDREN

List children below (1 in each box - leave unused blank):

Municipality (kommune) in Norway: 

Church Parish to which they belonged: 

EMIGRANT SHIP

Ship Name:        Departure Date: 

            Port: 

DESTINATION IN AMERICA

         Early:      Late: 

OCCUPATIONS/PROFESSIONS

 in Norway:      in America: 

ADDITIONAL INFORMATION

Name: 

Relationship to emigrant: 

Email:      Date: 

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