Representative Questionnaire | Okemah Community

Please remember only ONE submission per family to the Research Committee

Family Name *

Please enter the FAMILY NAME

Name of Family Representative *

First

Last

Address *

City, State, and Zip Code *

Phone(s)

Please use the best contact phone number

1. Fraternal Grandfather.

2. Birth Place.

3. Military branch, rank and years served.

4. Fraternal Grandmother (first and maiden name).

5. Birth Place.

6. Military branch, rank and years served.

7. Maternal Grandfather.

8. Birth Place.

9. Military branch, rank and years served.

10. Maternal Grandmother (first and maiden name).

11. Birth Place.

12. Military branch, rank and years served.

13. Father/Other.

14. Birth Place.

15. Military branch, rank and years served.

16. Mother/Other (first and maiden).

17. Birth Place.

18. Military branch, rank and years served.

19. Why did they leave their birth place?

20. How did they travel?

21. Who did they bring with them?

22. What year did they settle in Okemah?

23. What work did they do when they arrived in Okemah?

24. Did they work an eight-hour job?

25. What skills or mastered skills did they have?

26. Did they purchase land in Okemah (list address or cross street, if remembered)?

27. Did they purchase land for agricultural, home, business or something else (list address or cross street, if remembered)?

28. What business did they owned (list address or cross street, if remembered)?

29. Was the home or business built by a construction company or help from friends?

30. What kind of home was it (adobe, wood, barrack, brick, block or trailer)?

31. Did they get a mortgage loan?

32. Did the home have propane/butane, water and electric when it was first built?

33. Elementary School children attended.

34. Junior High and High School children attended.

35. What did the family do for fun?

36. Where did the family shop for groceries (list address or cross street, if remembered)?

37. Where did the family shop for clothing (list address or cross street, if remembered)?

38. Did your family receive health care from a private doctor or clinic (name doctor(s) if remembered)?

39. What city did they travel to for health care?

40. What church did they attend (list address or cross street, if remembered)?

41. What position did they hold or duties they performed in the church?

42. What job did they retire from?

Additional Information.