We are attempting to gather information about the people interred. You may print out this page or download the pdf here.
Complete the form and mail to us at: P.O. Box 566, Keno, OR 97627.
We appreciate any information provided to us.
Keno Public Cemetery Family Questionnaire
Full Name of person or relative:_______________________________________________________________________________________
Date of Birth: ________________________ Location of Birth:_____________________________________________________________
Date of Death: _________________________Location of Death:__________________________________________________________
What do you know about the family surname? Its origin & meaning?_______________________________________________________
_______________________________________________________________________________________________________________________
Has the spelling been changed at some time in the past? _______________________________________________________________
_______________________________________________________________________________________________________________________
Did they serve in any wars? If so, which war and which branch of the service?: ________________________________________
_______________________________________________________________________________________________________________________
_______________________________________________________________________________________________________________________
_______________________________________________________________________________________________________________________
_______________________________________________________________________________________________________________________
Occupation(s):_________________________________________________________________________________________________________
Relatives name & birthdates: __________________________________________________________________________________________
_______________________________________________________________________________________________________________________
_______________________________________________________________________________________________________________________
_______________________________________________________________________________________________________________________
Other information of interest: (their home, life, special memories, family recipes, etc.)______________________________
_______________________________________________________________________________________________________________________
_______________________________________________________________________________________________________________________
_______________________________________________________________________________________________________________________
_______________________________________________________________________________________________________________________
Please complete as much information as possible, use another blank page if more room is needed.
Mail completed form to: Keno Cemetery - PO Box 566- Keno, OR 97627
or e-mail the information to: kenocemetery@yahoo.com
Your name, mailing address & e-mail address: __________________________________________________________________________
_______________________________________________________________________________________________________________________
_______________________________________________________________________________________________________________________
(We will not sell or rent your information to anyone.)
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