Application For Life Membership Form - Sons Of Confederate Veterans - North Carolina Division

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North Carolina Division
Sons of Confederate Veterans
Application for Life Membership
I, ____________________________________________SCV ID #_________________
a member in good standing in the __________________________________________
Camp #_______________, of the city of______________________________________
on this __________ day of________________, in the year ____________, respectfully
request Life Membership in the North Carolina Division, Sons of Confederate Veterans.
Enclosed is a check for the age appropriate amount designated below:
( ) Age 12 – 64 $375.00
( ) Age 65 – 79 $187.50
( ) Age 80+ $93.75
Print member name___________________________________________________
Legal Signature______________________________________________________
Address____________________________________________________________
City____________________________________ State_______ Zip Code________________
Phone__________________________email________________________________________
Payment is made directly to the Division Adjutant either through the member’s camp or directly
through the member. Make check payable to NC Division SCV and send to:
Danny Bolick
3445 Sigmont Dr.
Claremont, NC 28610

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