Genealogy Request Form

After you submit this form, our staff will contact you.

Your First Name

Your Last Name

Email

Phone Number

I am interested in: Genealogy researchDonating to the museum collectionParticipating in the oral history projectOther

If you are interested in geneaology, please fill out this section to the best of your ability.

First Name of Your Relative

Last Name of Your Relative

Relative's connection to the penitentiary: PrisonerStaff memberOther

If other, please clarify:

When was your relative at Eastern State?

If known, list your relative's prisoner number:

If known, list the crime for which your relative was convicted:

Please list any additional details about your relative that could assist with our research (date and/or location of crime, victim name, date of release from ESP, etc.):

Additional information about your inquiry:

Would you like to subscribe to Eastern State's e-newsletter? YesNo

Please attach up to five JPGs or PDFs you think might be helpful for our research.