Your Input

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We would welcome your input to our ongoing research project.  If you can tell us more about any of the individuals who appear on the database, please enter as much information as possible on this form.  Thank you!

Passenger surname		Forename(s)
Database index no		Birthplace
Date of death		Place of death
Main country of residence	Select USA Canada Australia New Zealand South Africa England Scotland Wales Ireland Other(specify)
Length of residence	Select Permanent Less than 1 year 1 - 5 years 6 - 10 years 11 - 15 years 16 - 20 years 21 - 25 years 26 - 30 years Over 30 years	Other countries of residence
Please add any other information that may be of interest (e.g. career information; survival of letters, diaries, photographs)
Are you willing for the information you have provided about the passenger to be added to the online database?			yes no
Your name		Email
Relationship to passenger