The Family Book Project: Recording Our History
The Questionnaire
Personal Full name______________________________________________________________________ Appearance Color of eyes:________________________________________ Childhood What were your favorite toys? Education What was the highest grade/level that you completed in schooling?__________________________ Growing Up What was your high school experience like? Armed Services Have you served in the armed services/special forces/etc?_____________________________ Marriage Spouse(s) (and years):_____________________________________________________________ Family Children (gender and birthdates):____________________________________________________ Home List the places that you have lived (continue in notes section, if necessary): Career What were/are your occupation(s) (and when)?__________________________________________ Hobbies What were/are your hobby(s) (and when)? _____________________________________________ Life in General Your best friends (and period of life you knew them): A Life Well-Lived List any awards you received: Favorites (Answer these based on your whole life, listing multiple answers if necessary) History Recall any special historical events and your remembrance of them, ex: the landing on the moon, assassination of JFK, September 11, Pearl Harbor, etc. Other I have published a work(s): Follow-up Phone number we may reach you at for further questions: _________________________ Finish Date questionnaire completed: ________________________ Notes This section is meant either for you to expound on earlier questions, or to share with us whatever you think is important/whatever you find memorable about your life.
Name at birth___________________________________________________________________
Nicknames (and who called you them in parenthesis)
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Birthdate:_______________________________________
Birth place (city, state, country):_____________________________________________________
Hospital:_______________________________________________________________________
Birth time:_____________________
Weight and height:_________________________________
Biological mother:____________________________________(maiden name)________________
Biological father:_________________________________________________________________
Were you adopted (and adoptive parents names)? _______________________________________
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Deathdate (if applies): ______________________________________
Cause of death: __________________________________________________________________
Nationality: _____________________________
Political persuasion: ______________________________
Religion: ______________________________
Blood Type: _____________
Allergies: ______________________________________________________________________
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Parents divorced? Date?____________________________________________________
Step mother(s) (and years):_________________________________________________________
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Step-father(s) (and years):__________________________________________________________
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Siblings (full names and birthdates):__________________________________________________
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List ten words that best describe you:
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Ask three other people to give three words each describing you:
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Color of hair:________________________________________
Skin tone:___________________________________________
Ethnicity:___________________________________________
Average height during adulthood:___________
Average show size during adulthood:________
Average weight during adulthood: _________
Birthmarks: ____________________________________________________________________
Scars: _________________________________________________________________________
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Distinguishing features: ___________________________________________________________
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Physical family characteristics: ______________________________________________________
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Body modifications (tattoos, piercings, etc.) and describe: _________________________________
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Describe your clothing style: _______________________________________________________
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Hair dye color and when: __________________________________________________________
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Do you wear glasses/contact, and when? _______________________________________________
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What were your favorite pastimes as a child?
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What was your family experience like?
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Describe dinnertime at your house: __________________________________________________
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Describe evening at your house: _____________________________________________________
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Describe weekends at your house: ___________________________________________________
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Who were your childhood heroes and why?
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Who was your first boyfriend/girlfriend and when?
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Who was your first kiss and when?
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What were the cool styles when you were a kid/teenager?
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Did you ever skip a year/flunk a grade/attend special schooling? explain.
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Elementary school(s), years and city/state:
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Junior high/middle school(s), years and city/state:
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High school(s), years and city/state:
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________________________________________________________________G.P.A:_________
Trade school(s), years and city/state:
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________________________________________________________________G.P.A:_________
College/University(s), years, major(s), degree(s) and city/state:
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________________________________________________________________G.P.A:_________
Grad school/other higher education(s), major(s), degree(s), years and city/state:
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Extracurricular activities and grade in which you participated in them:
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Special school accomplishments:
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Who was your favorite teacher and why?
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What was your favorite year in school and why?
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What kinds of student were you? What kind of grades did you get and why?
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Tell about your �Sweet 16�:
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Tell about the day you got your driver�s license:
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Where were your drivers licensed issued, and when?
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What was your first car: ______________________________________________________
What was your favorite car (which you owned): _________________________________________
Tell about getting your driver�s license:
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Tell about your high school prom:
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Did you have a job while in school?
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Where was your �hang out� and what did you do there?
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Tell about some important milestones:
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In general, tell about your family tree:
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What sports did you play and when?
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What sports did you enjoy watching?
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How often did you drink/smoke and when? ___________________________________________
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What drugs have you tried and when? ________________________________________________
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Explain any criminal history: _______________________________________________________
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List any traffic violations: __________________________________________________________
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What kind of driver are you? _______________________________________________________
How did you spend your time as a young adult?
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Country you served for:_________________________
Dates of service:___________________________________________
Rank:______________________________
Where you served:________________________________________________________________
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Wars you served in:_______________________________________________________________
Honors:________________________________________________________________________
Tell about your experience:
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Anniversary(s):__________________________________________________________________
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Wedding location(s):______________________________________________________________
Wedding licensed in what city/state/country:___________________________________________
Wedding officiate(s):______________________________________________________________
Wedding music:_________________________________________________________________
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Wedding colors:_________________________________________________________________
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Wedding flowers:________________________________________________________________
Wedding party:
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Share about your wedding day(s):
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Where did you honeymoon?________________________________________________________
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Share a memorable anniversary:
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Share a memorable day in your marriage:
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Tell about your spouse(s):
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What was it like when your first child was born?
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Tell about a great moment you had in parenthood:
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Tell about a humbling moment you had in parenthood:
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What was your family experience like?
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Describe dinnertime at your house: __________________________________________________
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Describe evening at your house: _____________________________________________________
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Describe weekends at your house: ___________________________________________________
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Tell about a cherished family tradition:
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Tell about a great family vacation:
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What pets have you had (and when and what were their names)?
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What holidays are important to you and how do you celebrate them?
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1. Address _____________________________________________________________________
Phone Number _________________________________________________________________
Description of house _____________________________________________________________
Description of neighborhood _______________________________________________________
Time lived there _________________________________________________________________
2. Address _____________________________________________________________________
Phone Number _________________________________________________________________
Description of house _____________________________________________________________
Description of neighborhood _______________________________________________________
Time lived there _________________________________________________________________
3. Address _____________________________________________________________________
Phone Number _________________________________________________________________
Description of house _____________________________________________________________
Description of neighborhood _______________________________________________________
Time lived there _________________________________________________________________
4. Address _____________________________________________________________________
Phone Number _________________________________________________________________
Description of house _____________________________________________________________
Description of neighborhood _______________________________________________________
Time lived there _________________________________________________________________
5. Address _____________________________________________________________________
Phone Number _________________________________________________________________
Description of house _____________________________________________________________
Description of neighborhood _______________________________________________________
Time lived there _________________________________________________________________
6. Address _____________________________________________________________________
Phone Number _________________________________________________________________
Description of house _____________________________________________________________
Description of neighborhood _______________________________________________________
Time lived there _________________________________________________________________
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What job did you enjoy the most and why? ____________________________________________
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What job did you hate and why?_____________________________________________________
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What career-related thing are you most proud of? _______________________________________
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Approximate annual income at 15: _____________________
Approximate annual income at 20: _____________________
Approximate annual income at 25: _____________________
Approximate annual income at 30: _____________________
Approximate annual income at 40: _____________________
Approximate annual income at 50: _____________________
Approximate annual income at 60: _____________________
Approximate annual income at 80: _____________________
When you retired: ________________
Tell about retirement:
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What organizations have you belonged to and when?
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What do you do to relax/repose?
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What do you do to exercise?
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What is your favorite outdoor activity? ________________________________________________
What is your favorite indoor activity? _________________________________________________
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Who do you most admire and why?
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What was your most memorable birthday and why?
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List any illnesses/diseases you have had and when you suffered from them. (This will be especially important for identifying risk in the younger family members.):
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Have you had any operations and when? _____________________________________________
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Have you been in the hospital? Explain. _______________________________________________
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List the places you have traveled, and when:
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What physical objects mean a lot to you:
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What non-physical things mean a lot to you:
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How do you feel about money?
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Tell about how you manage(d) money:
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Charities to which you donated and when:
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Magazines/newspapers to which you subscribed and when:
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What church/temple have you attended and when?
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Do you practice your religion and how?
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Describe your eating habits/diet:
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Your philosophy on life:
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What social issues concern you and how do you react?
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Causes you have championed and how:
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An important compliment you have received and from whom:
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You are very good at: _____________________________________________________________
The greatest physical pain you have endured: ___________________________________________
A heart-break you suffered: ________________________________________________________
What compulsive habits do you have?
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A lesson you learned the hard way:
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Your predominant emotions: _______________________________________________________
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Things you fear:
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Tell about a natural disaster you have witnessed:
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Your best year, and why:
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Your worst year, and why:
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How do you decorate your house?
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What is your goal in life?
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List any special accomplishments you have made:
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Were you wealthy or poor? Explain.
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What was the best time in your life?
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When was the happiest moment of your life?
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What advice would you give to your ancestors?
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What is your favorite color?
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What is your favorite TV show?
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What is your favorite radio show?
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What is your favorite movie?
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Who is your favorite actor?
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Who is your favorite actress?
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What is your favorite book?
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Who is your favorite author?
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Who is your favorite artist?
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What is your favorite band?
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Who is your favorite musician?
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What is your favorite type of music?
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Who is your favorite cartoon character/comic?
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Who is your favorite historical figure?
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Who is your favorite sports figure?
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What is your favorite food?
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What is your favorite meal?
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What is your favorite drink?
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What is your favorite restaurant?
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Where is your favorite place to visit?
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What is your favorite invention?
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What is your favorite smell?
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What is your favorite perfume/cologne?
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What is your favorite outfit to wear?
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What is your favorite store?
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Recall any nostalgic moments in time and your remembrance of them, ex: when TV came out, when you got your first microwave or hula hoop, when you watched The Simpsons for the first time, etc.
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Famous or notable relative/friend: __________________________________________________
Notable event you attended (and describe): ____________________________________________
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Notable person you met/knew (and describe): __________________________________________
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I am in a publication:
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Do you keep a journal/diary and at what age? __________________________________________
I have made a CD(s):
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I have a copyright:
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I have a patent:
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Current address: _________________________________________________________________
Webpage: __________________________________________________
Email address: ________________________________________________
Other family members (and their phone numbers) we may contact for information regarding you:
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Close friends (and their phone numbers) we may contact for information regarding you:
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Preparer: _________________________________________
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Add more sheets of paper if necessary. and FEEL FREE TO ADD ANY INFORMATION OR STORIES THAT YOU WOULD LIKE TO!
