POLISH GENEALOGICAL SOCIETY OF MASSACHUSETTS
Surname Project
The Polish Genealogical Society of Massachusetts publishes a list of Surnames on its website, www.PGSMA.org, for the purpose of assisting our members with
their research of family names. If you are interested in participating, please complete and return this form by mail or in person at one of the PGSMA regularly
scheduled meetings. Participation in the Surname Project is included in your annual membership fee. Please note the following important information:
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In the Contact Information column, enter your desired method of contact. This can be your e-mail address, your phone number, or your mailing address.
Interested parties who may be researching the same name(s) as you will use this information to connect with you. If you prefer not to provide your
personal contact information, you can enter “Contact PGSMA” instead. Interested individuals who want to contact you can provide their name and
contact information to the PGSMA by e-mail. A PGSMA director will then notify you of this information so that you can connect with that person at your
convenience. Please let us know how you want to be contacted (choose one):
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Email: _______________________
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Phone: ________________
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Mail: _______________________________________________
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Enter as much information about the individual you are researching as you know (see sample below). You may list as many names as you wish. Please
print or type your information so that it is legible.
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It is your responsibility to notify the PGSMA of any change in your contact information. You may submit additional forms at any time to add or
delete names, or to provide updated information for names you have already submitted.
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If you have any questions you may contact Barbara Kulig at bkulig@charter.net. Thank you for your interest!
SURNAME
Pasierb
FIRST
NAME
Tomas
PLACE OF ORIGIN
NEW LOCATION
ARRIVAL
Blonie – Galicia, Austria
Ludlow, MA →
Wilbraham, MA
1/7/1903
Surname Form – Revised Sept 2015
MEMBER
Terri (Lentowski) Colelli
CONTACT
INFORMATION
Colelli51@msn.com