Member Reinstatement Form
Please input all information for the Lapsed Member being Reinstated
Member Prefix
Last Name *
First Name *
Middle Name
Suffix
Address *
Please list the Complete Address - this is needed to mail the Confederate Veteran
City *
State *
Zip Code *
Home Telephone #
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
Division Adjutant use only
National Status
Division Adjutant use only
Member Birthdate
MM
/
DD
/
YYYY
Recommended by: *
SCV member name recommending 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
Served Until Date
Ancestor Birth date
MM
/
DD
/
YYYY
Ancestor Death date
MM
/
DD
/
YYYY
Buried at
List the name of the Cemetery
Ancestor Comments
Any other information
Has the Member, that has been Lapsed for more than a year, that is Being Reinstated been Voted on by the Camp *
SC Division Constitution, Article XI, Finance, Section 8. A suspended member may be reinstated to active membership upon payment of all back dues within one year of the deadline, together with all additional levies for that year. A member suspended for more than one year shall only be reinstated upon vote of the Camp and payment of all amounts owed for the current year.
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