GREAT GRANDDAUGHTER'S CLUB
UNITED DAUGHTERS OF THE CONFEDERACY®
NORTH CAROLINA DIVISON
Membership Application
NAME____________________________________________________________________________________
__________
Given Middle Maiden Surname
ADDRESS_________________________________________________________________________________
__________
Street City NC zip+4
CHAPTER NAME AND
NUMBER________________________________________________________________________
GREAT
GRANDFATHER____________________________________________________________________________
___
SERVICE__________________________________________________________________________________
__________
Company Regiment State Branch
PLACE OF
BURIAL___________________________________________________________________________________
_
Cemetery City County State
TYPE OF
MARKER__________________________________________________________________________________
__
MEMBER'S SIGNATURE___________________________________________
____________________________________
DATE__________________
DUES ARE $5.00 PER YEAR.
MAKE CHECK PAYABLE TO YOUR CHAPTER
PLEASE SEND A COPY OF YOUR MEMBERSHIP CERTIFICATE OR SUPPLEMENTAL PROVING YOUR
GREAT GRANDFATHER.
CHAPTER TREASURERS OR GGD REPRESENTATIVES: PLEASE MAIL ONE LIST AND ONE CHECK TO
Margaret Sink, Treasurer, NC GGC, 706 Prestwick Drive, Nashville, NC 27856-1682.
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Date received____________________ Date mailed to General_____________
Paid by Personal Check_____ Cash_____ Chapter Check______
Revised 3/2007