Your name: (As you want it to appear on your Name Tag)
Your complete street address: (Where you wnat your name tag mailed)
Your telephone number:
Your e-mail address:
Camp Name: (as you want it on your name tag)
Camp Number:
If desired, you can order a bar showing the Rank of your office. ($8.00 each).
Name of the office you hold, i.e., Commander, Adjutant, etc.:
Information for each Confederate Ancestor that you wish to order a hanging bar for ($8.00 each).
Rank and Name of Confederate Ancestor:
Military Unit: (How you want it to appear on the bar.)
Rank and Name of 2nd Confederate Ancestor: (if any)
Rank and Name of 3rd Confederate Ancestor: (if any)
Rank and Name of 4th Confederate Ancestor: (if any)
Rank and Name of 5th Confederate Ancestor: (if any)
For additional bars, please use the "Comments" below using the same format as above.
Comments: