Jack N Scudder Gillmar Jack N Scudder Gillmar Posts5 Member & Family Information Form Member & Family Information Step 1 of 6 16% Your Personal InformationPrefixNoneMr.Ms.Mrs.MissDr.Prof.Rev.LCDRCDRENSLTJGCAPTCPTLTCCOLBRIGGENLTGENMAJGENGEN2LTLTSGTSSGTTSGT1STGTSMSGTCMSTGPO3PO2PO1CPOSCPOMCPOMCPONName First Middle Last SuffixBirth PlaceBirth Date MM slash DD slash YYYY Preferred PhoneHomeMobileWorkPhoneAddress Street Address Address Line 2 City State / Province / Region ZIP / Postal Code AfghanistanAlbaniaAlgeriaAmerican SamoaAndorraAngolaAnguillaAntarcticaAntigua and BarbudaArgentinaArmeniaArubaAustraliaAustriaAzerbaijanBahamasBahrainBangladeshBarbadosBelarusBelgiumBelizeBeninBermudaBhutanBoliviaBonaire, Sint Eustatius and SabaBosnia and HerzegovinaBotswanaBouvet IslandBrazilBritish Indian Ocean TerritoryBrunei DarussalamBulgariaBurkina FasoBurundiCabo VerdeCambodiaCameroonCanadaCayman IslandsCentral African RepublicChadChileChinaChristmas IslandCocos IslandsColombiaComorosCongoCongo, Democratic Republic of theCook IslandsCosta RicaCroatiaCubaCuraçaoCyprusCzechiaCôte d'IvoireDenmarkDjiboutiDominicaDominican RepublicEcuadorEgyptEl SalvadorEquatorial GuineaEritreaEstoniaEswatiniEthiopiaFalkland IslandsFaroe IslandsFijiFinlandFranceFrench GuianaFrench PolynesiaFrench Southern TerritoriesGabonGambiaGeorgiaGermanyGhanaGibraltarGreeceGreenlandGrenadaGuadeloupeGuamGuatemalaGuernseyGuineaGuinea-BissauGuyanaHaitiHeard Island and McDonald IslandsHoly SeeHondurasHong KongHungaryIcelandIndiaIndonesiaIranIraqIrelandIsle of ManIsraelItalyJamaicaJapanJerseyJordanKazakhstanKenyaKiribatiKorea, Democratic People's Republic ofKorea, Republic ofKuwaitKyrgyzstanLao People's Democratic RepublicLatviaLebanonLesothoLiberiaLibyaLiechtensteinLithuaniaLuxembourgMacaoMadagascarMalawiMalaysiaMaldivesMaliMaltaMarshall IslandsMartiniqueMauritaniaMauritiusMayotteMexicoMicronesiaMoldovaMonacoMongoliaMontenegroMontserratMoroccoMozambiqueMyanmarNamibiaNauruNepalNetherlandsNew CaledoniaNew ZealandNicaraguaNigerNigeriaNiueNorfolk IslandNorth MacedoniaNorthern Mariana IslandsNorwayOmanPakistanPalauPalestine, State ofPanamaPapua New GuineaParaguayPeruPhilippinesPitcairnPolandPortugalPuerto RicoQatarRomaniaRussian FederationRwandaRéunionSaint BarthélemySaint Helena, Ascension and Tristan da CunhaSaint Kitts and NevisSaint LuciaSaint MartinSaint Pierre and MiquelonSaint Vincent and the GrenadinesSamoaSan MarinoSao Tome and PrincipeSaudi ArabiaSenegalSerbiaSeychellesSierra LeoneSingaporeSint MaartenSlovakiaSloveniaSolomon IslandsSomaliaSouth AfricaSouth Georgia and the South Sandwich IslandsSouth SudanSpainSri LankaSudanSurinameSvalbard and Jan MayenSwedenSwitzerlandSyria Arab RepublicTaiwanTajikistanTanzania, the United Republic ofThailandTimor-LesteTogoTokelauTongaTrinidad and TobagoTunisiaTurkmenistanTurks and Caicos IslandsTuvaluTürkiyeUS Minor Outlying IslandsUgandaUkraineUnited Arab EmiratesUnited KingdomUnited StatesUruguayUzbekistanVanuatuVenezuelaViet NamVirgin Islands, BritishVirgin Islands, U.S.Wallis and FutunaWestern SaharaYemenZambiaZimbabweÅland Islands Country Email Desired email addressAlternative Email Other emails you may use to communicate with us.Preferred Email?PersonalWorkScudder.orgAlternateCurrentHow would you like to be contacted?EmailPhoneMailingAlternate EmailScudder.orgAre you a Scudder? Yes No Parents DetailsParent PrefixNoneMr.Ms.Mrs.MissDr.Prof.Rev.LCDRCDRENSLTJGCAPTCPTLTCCOLBRIGGENLTGENMAJGENGEN2LTLTSGTSSGTTSGT1STGTSMSGTCMSTGPO3PO2PO1CPOSCPOMCPOMCPONParent Name First Middle Last Parent SuffixParent BirthplaceParent Birthday MM slash DD slash YYYY Is your Parent Living Yes No Parent Deceased Date MM slash DD slash YYYY Parent Deceased PlaceYou may visit the Scudder Ancestor in America Genealogical Database to research your lineage and accuracy. Any errors or omissions need to be sent to the database administrators as we do not have access to their data. You can update our records with your ancestors information if you wish using this form.Last Generation Found in DatabaseNoneGreat GrandParentGrandParentParentSiblingSelfChildWould you like to include your family Information? Yes No Great Grand Parent NameGreat Grand Parent PrefixNoneMr.Ms.Mrs.MissDr.Prof.Rev.LCDRCDRENSLTJGCAPTCPTLTCCOLBRIGGENLTGENMAJGENGEN2LTLTSGTSSGTTSGT1STGTSMSGTCMSTGPO3PO2PO1CPOSCPOMCPOMCPONGreat Grand parent Name First Middle Last Great Grand Parent SuffixGreat Grand Parent BirthplaceGreat Grand Parent Birthdate MM slash DD slash YYYY Great Grand Parent Deceased Place(if Known)Great Grand Parent Deceased Date MM slash DD slash YYYY Grand Parents NameGrand Parent PrefixNoneMr.Ms.Mrs.MissDr.Prof.Rev.LCDRCDRENSLTJGCAPTCPTLTCCOLBRIGGENLTGENMAJGENGEN2LTLTSGTSSGTTSGT1STGTSMSGTCMSTGPO3PO2PO1CPOSCPOMCPOMCPONGrand Parent Name First Middle Last Grand Parent SuffixGrand Parent BirthplaceGrand Parent Birthdate MM slash DD slash YYYY Is your Grand Parent Living Yes No Grand Parent Deceased Place(if Known)Grand Parent Deceased Date MM slash DD slash YYYY Brothers or sister? Yes No How Many Brothers or Sisters?012345Sibling 1Sibling 1 PrefixNoneMr.Ms.Mrs.MissDr.Prof.Rev.LCDRCDRENSLTJGCAPTCPTLTCCOLBRIGGENLTGENMAJGENGEN2LTLTSGTSSGTTSGT1STGTSMSGTCMSTGPO3PO2PO1CPOSCPOMCPOMCPONSibling 1 Name First Middle Last Sibling 1 SuffixSibling 1 Birth PlaceSibling 1 Birth Date MM slash DD slash YYYY Is your Sibling 1 Living? Yes No Sibling 1 Deceased Place(If Known)Sibling 1 Deceased Date(If Known) MM slash DD slash YYYY Sibling 2Sibling 2 PrefixNoneMr.Ms.Mrs.MissDr.Prof.Rev.LCDRCDRENSLTJGCAPTCPTLTCCOLBRIGGENLTGENMAJGENGEN2LTLTSGTSSGTTSGT1STGTSMSGTCMSTGPO3PO2PO1CPOSCPOMCPOMCPONSibling 2 First Middle Last Sibling 2 SuffixSibling 2 Birth PlaceSibling 2 Birth Date MM slash DD slash YYYY Is Your Sibling 2 living? Yes No Sibling 2 Deceased Place(If Known)Sibling 2 Deceased Date(If Known) MM slash DD slash YYYY Sibling 3Sibling 3 PrefixNoneMr.Ms.Mrs.MissDr.Prof.Rev.LCDRCDRENSLTJGCAPTCPTLTCCOLBRIGGENLTGENMAJGENGEN2LTLTSGTSSGTTSGT1STGTSMSGTCMSTGPO3PO2PO1CPOSCPOMCPOMCPONSibling 3 First Middle Last Sibling 3 SuffixSibling 3 Birth PlaceSibling 3 Birth Date MM slash DD slash YYYY Is Your Sibling 3 living? Yes No Sibling 3 Deceased Place(If Known)Sibling 3 Deceased Date(If Known) MM slash DD slash YYYY Sibling 4Sibling 4 PrefixNoneMr.Ms.Mrs.MissDr.Prof.Rev.LCDRCDRENSLTJGCAPTCPTLTCCOLBRIGGENLTGENMAJGENGEN2LTLTSGTSSGTTSGT1STGTSMSGTCMSTGPO3PO2PO1CPOSCPOMCPOMCPONSilbing 4 First Middle Last Sibling 4 SuffixSibling 4 Birth PlaceSibling 4 Birth Date MM slash DD slash YYYY Is Your Sibling 4 living? Yes No Sibling 4 Deceased Place(If Known)Sibling 4 Deceased Date(If Known) MM slash DD slash YYYY Sibling 5Sibling 5 PrefixNoneMr.Ms.Mrs.MissDr.Prof.Rev.LCDRCDRENSLTJGCAPTCPTLTCCOLBRIGGENLTGENMAJGENGEN2LTLTSGTSSGTTSGT1STGTSMSGTCMSTGPO3PO2PO1CPOSCPOMCPOMCPONSibling 5 First Middle Last Sibling 5 SuffixSibling 5 Birth PlaceSibling 5 Birth Date MM slash DD slash YYYY Is Your Sibling 5 living? Yes No Sibling5 Deceased Place(If Known)Sibling 5 Deceased Date(If Known) MM slash DD slash YYYY Are you Married/Partnered Yes No Spouse / PartnerSpouse/Partner Name:Spouse PrefixNoneMr.Ms.Mrs.MissDr.Prof.Rev.LCDRCDRENSLTJGCAPTCPTLTCCOLBRIGGENLTGENMAJGENGEN2LTLTSGTSSGTTSGT1STGTSMSGTCMSTGPO3PO2PO1CPOSCPOMCPOMCPONSpouse Name First Middle Last Spouse SuffixSpouse Email Spouse Birthday MM slash DD slash YYYY Spouse BirthplaceIs your Spouse/Partner Living? Yes/No Yes No Anniversary Date MM slash DD slash YYYY Spouse Deceased Place (if known)Spouse Deceased Date (if known) MM slash DD slash YYYY Do You Have Children? Yes No How many children?012345Child 1Child 1 Name First Middle Last Suffix Child 1 Email Child 1 Birthday MM slash DD slash YYYY Child 1 BirthPlacesIs Child 1 Living? Yes No Child 1 Deceased PlaceChild 1 Deceased Date MM slash DD slash YYYY Child 2Child 2 name First Middle Last Suffix Child 2 Email Child 2 Birthday MM slash DD slash YYYY Child 2 BirthPlacesIs Child 2 Living? Yes No Child 2 Deceased PlaceChild 2 Deceased Date MM slash DD slash YYYY Child 3Child 3 name First Middle Last Suffix Child 3 Email Child 3 Birthday MM slash DD slash YYYY Child 3 BirthPlacesIs Child 3 Living? Yes No Child 3 Deceased PlaceChild 3 Deceased Date MM slash DD slash YYYY Child 4Child 4 name First Middle Last Suffix Child 4 Email Child 4 Birthday MM slash DD slash YYYY Child 4 BirthPlacesIs Child 4 Living? Yes No Child 4 Deceased PlaceChild 4 Deceased Date MM slash DD slash YYYY Child 5Child 5 name First Middle Last Suffix Child 5 Email Child 5 Birthday MM slash DD slash YYYY Child 5 BirthPlacesIs Child 5 Living? Yes No Child 5 Deceased PlaceChild 5 Deceased Date MM slash DD slash YYYY Have you an area of interest? Yes No Interest Topics to add: Philanthropy Philanthropy - Educational Grants Philanthropy - India Grants Membership (Stewardship) Annual Meeting - Reunion Account Questions Family History Other Other InterestsPlease tell us about your interests not listed above.CommentAnything else you would like share with the Foundation. If a response is required we get back to you.
