Request Form for Proof of Métis Ancestry | La Société historique de Saint-Boniface

**Please read the Proof of Métis Ancestry page before filling out this form. There is information you need to send in separately from this application. Also, please note that our office will only receive your request if it has been successfully submitted and paid for. Once you have submitted your request, you will automatically be transferred to Paypal where you will be given the option to pay with a Paypal account (if you have one) OR with a credit card. Thank you!

Note: If you or one of your Métis ancestors is adopted, contact the Membership Department at MMF Head Office (204-586-8474) for guidance in finding appropriate required documents BEFORE placing your order.

Family Name: *

Maiden Name (If applicable):

Given Name(s): *

Complete mailing address (street, postal box, RR #, etc.): *

City: *

Province: *

Postal Code: *

Telephone:

Email:

What information would you like us to find for you?:

Langue: *

French

English

Purchase Details: *

Proof of Métis Ancestry package including $3 postage* ($50 MMF rebate included) : $28

Ten-generation book (including $10 postage*) : $120

Twelve-generation book (including $15 postage*) : $165

Fifteen-generation book (including $25 postage*) : $205

* For addresses outside of Canada, an additional shipping fee will be added separately. Please contact us at shsb@shsb.mb.ca if you would like to receive a quote before submitting your order.

Client's consent: *

I agree to the following

I agree that should the research be inconclusive, I will not get a refund.

By filling out this form, I give the SHSB the right to use my contact information exclusively for the purposes of sending me information related to the preservation and promotion of heritage.

I also give permission to the SHSB to enter the genealogical information provided into their historical and genealogical databases to produce more accurate genealogical products.

No changes will be made to your genealogy after three months of the date confirming the work has been completed.

Centre du patrimoine, 340, boulevard Provencher, Saint-Boniface, (Manitoba) R2H 0G7 - T(204) 233-4888	©2010 - Société historique de Saint-Boniface
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