DV Submitter Request Form

"The Pomeranian People"

QUARTERLY PERIODICAL FOR THE DESCENDENTS OF THE BALTIC DUCHY OF POMERANIA

Pomeranian Special Interest Group
2117 Oakmount Drive
Riviera Beach, Florida 33404, U.S.A.

Dear Librarians:

Please send me last known address for the Die Pommerschen
Leute submitters that correspond to the following entries in
the Village Index:

Village Name ...... County Name ..... Submitter Number

1._____________________________________________________________

2._____________________________________________________________

3._____________________________________________________________

4._____________________________________________________________

5._____________________________________________________________

I have included a donation of US$5.00 for the submitter addresses of up to five Village Index entries.

Please send the information to:

Name:___________________________________________

Street:___________________________________________

City:_____________________________________________

Zip:_____________