This questionnaire was developed by Am haZikaron, as a start point for your family research journey. The more information you provide below, the more we will be able to tell you about your family history. Please mark a "Jew" field, in case any connection to Jewish people exists. If you do not understand Russian, please indicate so in the Additional comments field. If you do, you can fill in Russian.Thank you!

My Generations

I am

First name:	Last name:
Birth year:	Birth place:
Occupation:	E-mail:

I am going to the Birthright trip organized by:

Group No:

Great-Grandfather

First name:	Last name:
Birth year:	Birth place:
Occupation:	Jew

Great-Grandmother

First name:	Maiden name:
Birth year:	Birth place:
Occupation:	Jew

Great-Grandfather

First name:	Last name:
Birth year:	Birth place:
Occupation:	Jew

Great-Grandmother

First name:	Maiden name:
Birth year:	Birth place:
Occupation:	Jew

Great-Grandfather

First name:	Last name:
Birth year:	Birth place:
Occupation:	Jew

Great-Grandmother

First name:	Maiden name:
Birth year:	Birth place:
Occupation:	Jew

Great-Grandfather

First name:	Last name:
Birth year:	Birth place:
Occupation:	Jew

Great-Grandmother

First name:	Maiden name:
Birth year:	Birth place:
Occupation:	Jew

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