No.

APPLICATION FOR MEMBERSHIP

o

Email Date/Time Field

TO THE SECRETARY and REGISTRAR OF

The Pilgrim Society

(INCOROPORATED)

I, the undersigned, hereby apply for membership in this Society by right of descent from

John Howland

The 13th signer of the Compact

…and…

Elizabeth Tilley Howland

His Wife

Who were passengers on the , on the voyage which terminated in

Plymouth, New England, in December 1620.

Name of Applicant

Address of Applicant

Occupation of Applicant

Signature Field Date/Time Field

Statement of Line of Eligibility for Membership in the

Pilgrim John Howland Society

(every name of a person must be written in full - do not use initials) 1. JOHN HOWLAND MARRIED

2 who married

3

PLACE DATE REFERENCES

b

d

m

married to parents

b

d

4

b

d

m

married to parents

b

d

5

b

d

m

married to parents

b

d

6

b

d

m

married to parents

b

d

Generations to same as GS # , State # 7

b

d

m

married to parents

b

d

8

b

d

m

married to parents

b

d

9

b

d

m

married to parents

b

d

10

b

d

m

married to parents

married

12

b

d

m

married to parents

b

d

13

b

d

m

married to parents

b

d

14

b

d

m

married to parents

b

d

15

b

d

m

married to parents

married

Applicants who have sons, daughters, brothers, or sisters, (these must be blood relations only) should furnish the following information for our records:

My , named , was born at

on , married at on to

My , named , was born at

on , married at on to

My , named , was born at

on , married at on to

My , named , was born at

on , married at on to

no

The Pilgrim John Howland Society

(INCOROPORATED) o

APPLICATION FOR MEMB ERSHIP

of

Application filed

Approved by Registrar

Elected Secretary

Notified

(All applicants please sign this acknowledgement)

I hereby state that the data and information furnished in this application are true to the best of my knowledge and belief, and the line of descent set forth is lineal and not in any case by adoption

Date/Time Signature

(Additional acknowledgement for applicants who are members of the )

I also certify that I am a member in good standing of the Society of Mayflower Descendants of the State of

having General No. and State No. , and that my line of descent from the Pilgrim John

Howland has been approved by them.

Date/Time Signature

The within application approved by the Registrar Registrar

The within-named applicant elected by the ecutive