HEARTS Reunion Genealogy Initiative
If you think you have a family connection to a regional plantation in Mecklenburg County or the surrounding area, please provide us your contact details and your family history information to the best of your knowledge.
Sign in to Google to save your progress. Learn more
Email *
Your Full Name
Email
Phone
Do you know which regional plantation(s) your ancestors may have connections to?  Please list plantation names:
Do you have ancestors who lived in the historical African American communities of Long Creek, Miranda, Smithville and/or Pottstown? Choose all that apply:
Do you have ancestors who were Native American and lived in this area?
Clear selection
Mother's Full Name (including maiden name)
Mother's Date and Location of Birth
If deceased, please include date of death and burial location.
Father's Full Name
Father's Date and Location of Birth
If deceased, please include date of death and burial location.
Maternal Grandmother's Full Name
Maternal Grandmother's Date and Location of Birth
If deceased, please include date of death and burial location.
Is there any other information you'd like to include regarding your maternal (mother's side) ancestors and their connection to plantation(s)?
Maternal Grandfather's Full Name
Maternal Grandfather's Date and Location of Birth
If deceased, please include date of death and burial location.
Is there any other information you'd like to include regarding your maternal (mother's side) ancestors and their connection to plantation(s)?
Paternal Grandmother's Full Name
Paternal Grandmother's Date and Location of Birth
If deceased, please include date of death and burial location.
Is there any other information you'd like to include regarding your paternal (father's side) ancestors and their connection to plantation(s)?
Paternal Grandfather's Full Name
Paternal Grandfather's Date and Location of Birth
If deceased, please include date of death and burial location.
Is there any other information you'd like to include regarding your paternal (father's side) ancestors and their connection to plantation(s)?
Confirm that you have willfully provided this information.
Clear selection
I understand that the HEARTS Reunion project may research my ancestry, my family connection to regional plantations, and may contact me with follow up questions. This information provided may be included in a HEARTS Reunion database to help others identify their connections to plantations and to other HEARTS Reunion project participants. Also, this information provided may be used for further research and or publication by the HEARTS Reunion project.  
Clear selection
If you would like this information restricted, please provide details and restrictions:
Submit
Clear form
Never submit passwords through Google Forms.
This form was created inside of Lake Norman Realty, Inc.. Report Abuse