Midwest Historical
and
Genealogical Society

Wichita, Kansas

Midwest Historical and Genealogical Society
Sedgwick County, Kansas Pioneer Certificate

1. Midwest Historical and Genealogical Society is pleased to announce that we will issue certificates to direct descendants of pioneers who settled in Sedgwick County, Kansas, between February 26, 1867 and December 31, 1880.

2. Applicants must send photocopies of documentation for each generation. DO NOT SEND ORIGINALS. These copies will become the property of MHGS to publish in the future and for our files.

3. You do not have to be a resident of Sedgwick County.

INSTRUCTIONS

1. Complete form #1 and #2 to the best of your ability. If you are not sure of data, place a question mark behind it. Please use maiden names when they apply.

2. Complete the pedigree chart for yourself, make sure it includes your Sedgwick County Pioneer. This may be computer made. For each ancestor on the pedigree chart, prepare a 3x5 index ancestor card. Place your name and address on the reverse side.

3. If you wish to present additional material about your ancestor, use the back of the sheet or another sheet of paper.

4. Documentation must accompany the application. This documentation may be: census, birth records, death records, school or church records, Bible records, military records, land records, obituaries, estate records, tombstone inscriptions (give location of cemetery) or county histories. Send PHOTOCOPIES only. All materials will become the property of MHGS.

5. Send a check payable to MHGS. The amount due from members of MHGS is $7.00 (US Dollars only); for non-members the amount is $10.00 (US Dollars only). In the envelope you should include: your check, the application form, the ancestors cards, the pedigree chart, and copies of proof. The fee is not refundable.

6. If you have more than one ancestor eligible for this certificate, send the required documentation for each one. Include an additional $3.00 (US Dollars only) for each additional ancestor, sent at the same time as the original.

7. Additional certificates for the same ancestor (different descendants) will be issued for an additional $3.00 (US Dollars only) if ordered at the same time. Mail to MHGS, Attention Pioneer Certificates, P.O. Box 1121, Wichita, KS 67201-1121.

8. If you need additional forms you may (a) copy the form you have or (b) write to MHGS for additional forms.

Midwest Historical and Genealogical Society

FORM #1
Application for Certificate
Sedgwick County, Kansas Pioneer Certificate

(The following pertains to the person applying for the certificate)

NAME________________________________________________________________________
(As you want it written on the certificate)

ADDRESS _______________________________________________________________________________
Street, City, State, ZIP

(The following pertains to the direct ancestor of the above named person)

NAME OF PIONEER ______________________________________________________________________________
(As you want it written on the certificate)

FORM #2

A. (Applicant’s name) _____________________________________________ was born on

date __________________________, _____________ County, state of ______________

and married to ___________________________________________________________

B. I am the child of __________________________________ married to _______________

Born _____________________ Place ___________________________________

Married ___________________ Place __________________________________

Died _____________________ Place ___________________________________

C. Who was the child of _____________________________ married to_______________
Born _____________________ Place ___________________________________

Married ___________________ Place __________________________________

Died _____________________ Place ___________________________________

D. Who was the child of _____________________________ married to_______________
Born _____________________ Place ___________________________________

Married ___________________ Place __________________________________

Died _____________________ Place ___________________________________

E. Who was the child of _____________________________ married to_______________
Born _____________________ Place ___________________________________

Married ___________________ Place __________________________________

Died _____________________ Place ___________________________________

F. Who was the child of _____________________________ married to_______________
Born _____________________ Place ___________________________________

Married ___________________ Place __________________________________

Died _____________________ Place ___________________________________

PERMISSION RELEASE

I understand that the material submitted with this application and pedigree chart may be used in a published book at a latter date. I understand that the material submitted can be used by me should I decide to put it in print at a later date. I give permission to MHGS to use my material for their publications allowing the material to be edited as necessary.

DATE								SIGNATURE

___________________					______________________________

---------------------------------------------------------------------------------------------------
For Midwest Use Only

This certifies that I have checked the attached proof, that the ancestor of ____________________
was in Sedgwick County, KS as given by the applicant and that the statements are true to the best of the applicant’s knowledge. Certificate issued the ___________ day of _____________, _____

Sample of ancestor card:

			SEAL, Mary Magdelen			H-125
			b.    13 June 1844
			pb.  New Orleans, Louisiana
			d.    12 December, 1930
			pd.  Kingman, Kingman, Kansas
			pr.   Peter Seal
			       Magdalene Spangler
			M.   Eugen Rollmann
			m.    6 September 1866
			mp.  Peoria, Peoria, Illinois
			sp.   Carl Friedrich Rollmann
			       Henrietta Voerster

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