New Member Application

Please input all information on the New Member Application

Member Prefix

This is Default

Rev

Member Last Name *

Member First Name *

Member Middle Name *

Name Suffix

Street Address *

Please list the Complete Address

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 *

Brigade that the Camp is in

Camp Office

Division Office

Division Adjutant use only

National Office

Division Adjutant use only

Division Status

Division Adjutant use only

National Status

Division Adjutant use only

Camp Status

Division Adjutant use only

Member Birthdate

YYYY

Recommended

SCV member name who recommended new applicant

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 Date

Ancestor Birth Date

Ancestor Death Date

Buried at

List the name of the Cemetery

Ancestor Comments

Any other information

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