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| Her Majesty Queen Margrethe II of Denmark, Protector |
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| The Danish Immigrant Museum 2212 Washington Street P.O. Box 470 Elk Horn, Iowa 51531-0470 712.764.7001 © Since 1983; All Rights Reserved |
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| DANISH IMMIGRATION FORM Print and complete this form; mail to: The Danish Immigrant Museum Family History & Genealogy Center Danish Immigration Information 4210 Main Street P.O. Box 249 Elk Horn, Iowa 51531-0249 _________________________________________________________________________ Date: _____________________ Your (Sponsor) Name: _____________________________________________________ Relationship to Immigrant: _________________________________________________ Mailing Address: _________________________________________________ City: _______________________________ State: _________ ZIP: _________ Phone: ___________________________ E.Mail: _______________________ Please complete a separate form for each name. _________________________________________________________________________ Information Provided By: Same As Above: ___________ Name (When Different): _______________________________________________ Relationship to Immigrant: _________________________________________________ Mailing Address: _________________________________________________ City: _______________________________ State: _________ ZIP: _________ Phone: ___________________________ E.Mail: ______________________ _________________________________________________________________________ Immigrant Information: Include biographies, documentation, photos, and such. These may be included with this form or sent as E.Mail attachments to: info@danishmuseum.org Name of Immigrant: ______________________________________ Date of Birth: ______________________________________ Place of Birth: ______________________________________ Father: ______________________________________ Mother: ___________________________________________ Date of Marriage: ______________________________________ Place of Marriage: ___________________________________ Name of Spouse (include maiden name of wife): _________________________________ Date of Death: ______________________________________ Place of Death: _____________________________________ Occupation: ______________________ Religion: _________________ Military Service: ______________________________________ Other Places Lived: ________________________________________________________ Names of Children (Birth Year Optional): ____________________________________ _________________________________ ____________________________________ _________________________________ ____________________________________ _________________________________ ____________________________________ _________________________________ Emigrated From: ___________________________ On (Vessel): __________________________________ Port of Entry: ____________________________________________________________ Reason for Emigration: ___________________________________________________ Other Relatives Who Immigrated: ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ Additional Information & Family History Highlights: ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ ____________________________________________________________________________ (Continue listing any information on the back of form, or; as an additional document when needed.) _________________________________________________________________________ For Office Use Only: Received By: _____________________ Initials: ________________ Date: ____________ |
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