As we now have over 300 posters in our pioneer poster collection, we would like to ensure that a pioneer is not duplicated. To this end, would you please complete the form below and send back to the Pioneer Poster Coordinator at posters@pioneerssa.org.au.

Member’s name:	[Click type your full name here]
Member’s Number:	[Member no.]
Name of Pioneer:	[Click and type the name of your pioneer here]
Where your pioneer was married in the place of origin and travelled to SA with their spouse, please provide the spouse name (and maiden name if applicable) below.
Name of Pioneer spouse:	[Click and type the spouse name here]
Place of Departure:	[Click and type the place of departure here]
Date of Departure:	[Click and start typing the introduction here]
Date of Arrival in SA:	[Click and start typing the introduction here]
Place of Arrival in SA:	[Click and place of arrival here]
Name of Ship:	[Click and type the ship name here]
OR where your pioneer arrived in SA by other means, please provide the means of travel below.
Means of travel to SA:	[Click and the other means of travel here]
Please provide any additional information you think is relevant, below (optional)
[Click and type here]