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| Your Details |
| Name | Borders FHS Member No (if applicable) |
| Address |
| Post/Zip Code | Email Address |
| Information Wanted What is the information you're seeking ? Maximum time to spend (Minimum 30 minutes Maximum 2 hours) ? |
| Information You Know Please note - the more information you provide the more likely the search will be successful |
| Surname | Forename(s) |
| Additional names eg father/mother | |
| Event: eg birth, death, marriage, census | |
| Year (we will search 2 years on either side of your date) | |
| Other information which may help the search |
| Payment/Admin Details |
| Cheque/Visa/Mastercard (circle one) | Credit Card Number |
| Start Date | Expiry Date | Name (as it appears on card) | 3 digit security number |
| Society use only: | Received | Replied | Researcher |