Gomberg Family Site Questionnaire
Name:
EMail:
Q 1 : Are you or your ancestors from Russia?
Yes
No
Unsure
Q 2 : If so, where in Russia were they from?
Ukraine
Russia Proper
Baltic States
Q 3 : Were they of Jewish descent?
Yes
No
Unsure
Q 4 : In what year did they leave?
Q 5 : Would you like to recieve a correspondence from the Gomberg Family Site?
Yes
No
ABSOLUTELY!