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