Current Member Change Form

Please input all information for Member Information to be updated on the Camp Roster

SCV ID# *

Member Prefix

Rev

Member Last Name *

Member First Name *

Member Middle Name

Name Suffix

Street Address

Please list the Complete Address - this is needed to mail the Confederate Veteran

City

State

Postal Code

Home Phone #

Include Area Code

Work Phone #

Include Area Code

Fax Phone #

Include Area Code

Pager Phone #

Include Area Code

Mobile Phone #

Include Area Code

Email Address

Camp Name

Camp Number

Brigade *

Camp Office

Division Adjutant use only

Division Office

Division Adjutant use only

National Office

Division Adjutant use only

Division Status

National Status

Member Birthdate

YYYY

Recommended

Name of SCV Member the new member has been recommended by

Comments

Division Adjutant use only

Guardian

Division Adjutant use only

Guardian Date

Division Adjutant use only

Ancestor Prefix

If known

Ancestor First Name

Ancestor Middle Name

Ancestor Last Name

Ancestor Suffix

Optional

Relationship to Ancestor

If known

Branch

Branch of Military - Army, Navy, Marines

Regiment

Company

Rank

Served Until

Served Until Date

Ancestor Birth date

YYYY

Ancestor Death date

YYYY

Buried at

List the name of the Cemetery

Ancestor Comments

Any other information

Submit

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