Cemetery Census – Cemetery Survey Form - WVSSARwvssar.org/.../2016/02/SAR_Cemetery_Preservation_Survey_Form.pdf · Cemetery Census – Cemetery Survey Form Name of Cemetery and

Cemetery Census – Cemetery Survey Form

Name of Cemetery and any alternate names for the cemetery Location of the cemetery (not directions to the cemetery)(include GPS coordinates, if known) Directions to the cemetery from some major nearby community or intersection Other facts and notes about the cemetery (include your name and email here) Name (last, first middle, suffix)

Birth Date (dd Mmm yyyy)

Death Date (dd Mmm yyyy)

Picture Reference

Notes: (relationship, military service, age, etc.)

Cemetery Census – Cemetery Survey Form

Name (last, first middle, suffix)

Birth Date (dd Mmm yyyy)

Death Date (dd Mmm yyyy)

Picture Reference

Notes: (relationship, military service, age, etc.)

Cemetery Census – Cemetery Survey Form

Name (last, first middle, suffix)

Birth Date (dd Mmm yyyy)

Death Date (dd Mmm yyyy)

Picture Reference

Notes: (relationship, military service, age, etc.)

Cemetery Census – Cemetery Survey Form

Name (last, first middle, suffix)

Birth Date (dd Mmm yyyy)

Death Date (dd Mmm yyyy)

Picture Reference

Notes: (relationship, military service, age, etc.)

Cemetery Census – Cemetery Survey Form

Name (last, first middle, suffix)

Birth Date (dd Mmm yyyy)

Death Date (dd Mmm yyyy)

Picture Reference

Notes: (relationship, military service, age, etc.)

Cemetery Census – Cemetery Survey Form

Name (last, first middle, suffix)

Birth Date (dd Mmm yyyy)

Death Date (dd Mmm yyyy)

Picture Reference

Notes: (relationship, military service, age, etc.)