Research Intake | The Kinship & Memory Genetic Cooperative

Section 1: Client Information & Research Networks

Full Name *

Email Address *

Phone Number

Preferred Method of Contact

Family Reunion Groups, Research Associations & Social Media Accounts

Section 2: Genetic Data, GEDmatch, & DNA Findings

Testing Company

GEDmatch Kit Number

GEDmatch GEDCOM name or ID

Paternal Haplogroup (Y-DNA)

Maternal Haplogroup (mtDNA)

Significant Information Gained from DNA Testing

Section 3: African & African-American Ancestry Research

Have you taken any specific African ethnic group tests?

African & Gullah/Geechee names found in your research

Names passed down through generations

Gullah/Geechee connections

Section 4: Ancestry Checklist & Target Surnames

Section 5: Native American Enslavement & Freedmen of the Five Civilized Tribes

Have you found ancestors in records associated with these tribes?

Has any family member filed an application for tribal membership?

Section 6: Oral Histories & Illicit Trafficking (Post-1808)

Do you have family oral histories that suggest ancestors arrived after 1808 or via remote coastal areas?

Suspected smuggling routes or locations

Section 7: Stories of Resistance, Rebellion, and Liberation

Do family oral histories mention ancestors who ran away, self-emancipated, resisted capture, or fought back?

Connections to historic uprisings & rebellions

Stono Rebellion (1739, SC)Gabriel's Rebellion (1800, VA)Denmark Vesey Conspiracy (1822, SC)Nat Turner's Rebellion (1831, VA)Other local uprisings or insurrections

Other (please specify)

Did your ancestors escape to or have connections with Maroon communities?

Civil War, USCT, & Contraband Camps

Escaped to Union lines (Contrabands)Enlisted in the U.S. Colored Troops (USCT)Served in the Union NavyServed as spies, guides, or laborers for the Union Army

Names, regiments, or camp locations

Are there family stories about Emancipation being announced?

Did ancestors participate in Reconstruction-era politics?

Describe Emancipation / Reconstruction stories

Section 8: Historical Records & Connections to Slaveholders

Have you located your ancestors in the 1870 U.S. Census?

1870 Census link or details (state, county, page, enumeration district)

Have you located an ancestor on the Dawes Rolls or other tribal rolls?

Dawes Roll link, number, applicant number, or census card number

Known connections to former slaveholders / slaveowning families

Describe specific documents you have found or are searching for

Section 9: Known Futa Jallon (Guinea) Connections & Historical Ancestral Figures

Do you have DNA matches or oral histories that point to the Futa Jallon region of Guinea?

Describe any connections, matches, or stories

Historical figures & documented diasporan ancestors with known Futa Jallon links

Other (please specify)

Detailed context for any checked names above

Section 10: Known Slave Ships, Ports of Arrival & Timeline

Section 11: Locations & Geography

Section 12: Research Narrative & Primary Goal

Briefly describe the primary goal of your genealogical research

Family Groups to Research

Add up to three family groups. You can submit more later using the same email address.

Family group 1

Family surname *

Head of family

Gedmatch kit number

Gedmatch email

GEDCOM ID

Transcription notes / errors

Census page links

Transcription / errors for this census page

Section 13: Consent & Agreement

By submitting this form, I confirm that the information provided is true and accurate to the best of my knowledge, I am the owner of the DNA test data or have permission to share it, and I understand that genetic genealogy is a complex field and results can be uncertain.

I consent to Khepri Consultancy storing the information I provide for genealogy research purposes, and I understand I can request deletion at any time.

Section 1: Client Information & Research Networks

Full Name *

Email Address *

Phone Number

Preferred Method of Contact

Family Reunion Groups, Research Associations & Social Media Accounts

Section 2: Genetic Data, GEDmatch, & DNA Findings

Testing Company

GEDmatch Kit Number

GEDmatch GEDCOM name or ID

Paternal Haplogroup (Y-DNA)

Maternal Haplogroup (mtDNA)

Significant Information Gained from DNA Testing

Section 3: African & African-American Ancestry Research

Have you taken any specific African ethnic group tests?

African & Gullah/Geechee names found in your research

Names passed down through generations

Gullah/Geechee connections

Section 4: Ancestry Checklist & Target Surnames

Section 5: Native American Enslavement & Freedmen of the Five Civilized Tribes

Have you found ancestors in records associated with these tribes?

Has any family member filed an application for tribal membership?

Section 6: Oral Histories & Illicit Trafficking (Post-1808)

Do you have family oral histories that suggest ancestors arrived after 1808 or via remote coastal areas?

Suspected smuggling routes or locations

Section 7: Stories of Resistance, Rebellion, and Liberation

Do family oral histories mention ancestors who ran away, self-emancipated, resisted capture, or fought back?

Connections to historic uprisings & rebellions

Stono Rebellion (1739, SC)Gabriel's Rebellion (1800, VA)Denmark Vesey Conspiracy (1822, SC)Nat Turner's Rebellion (1831, VA)Other local uprisings or insurrections

Other (please specify)

Did your ancestors escape to or have connections with Maroon communities?

Civil War, USCT, & Contraband Camps

Escaped to Union lines (Contrabands)Enlisted in the U.S. Colored Troops (USCT)Served in the Union NavyServed as spies, guides, or laborers for the Union Army

Names, regiments, or camp locations

Are there family stories about Emancipation being announced?

Did ancestors participate in Reconstruction-era politics?

Describe Emancipation / Reconstruction stories

Section 8: Historical Records & Connections to Slaveholders

Have you located your ancestors in the 1870 U.S. Census?

1870 Census link or details (state, county, page, enumeration district)

Have you located an ancestor on the Dawes Rolls or other tribal rolls?

Dawes Roll link, number, applicant number, or census card number

Known connections to former slaveholders / slaveowning families

Describe specific documents you have found or are searching for

Section 9: Known Futa Jallon (Guinea) Connections & Historical Ancestral Figures

Do you have DNA matches or oral histories that point to the Futa Jallon region of Guinea?

Describe any connections, matches, or stories

Historical figures & documented diasporan ancestors with known Futa Jallon links

Other (please specify)

Detailed context for any checked names above

Section 10: Known Slave Ships, Ports of Arrival & Timeline

Section 11: Locations & Geography

Section 12: Research Narrative & Primary Goal

Briefly describe the primary goal of your genealogical research

Family Groups to Research

Add up to three family groups. You can submit more later using the same email address.

Family group 1

Family surname *

Head of family

Gedmatch kit number

Gedmatch email

GEDCOM ID

Transcription notes / errors

Census page links

Transcription / errors for this census page

Section 13: Consent & Agreement

I consent to Khepri Consultancy storing the information I provide for genealogy research purposes, and I understand I can request deletion at any time.

Genetic Genealogy & Ancestral Research Intake

Family group 1

Genetic Genealogy & Ancestral Research Intake

Family group 1