United Daughters of the Confederacyâ
                                                          Membership Application for the
                                          Great, Great, Great Granddaughters Club of General
                               The Charter Application, Organized November 8, 2009, Biloxi, MS

Name:  _____________________________________________________________________

Address: ____________________________________________________________________

City:  ______________________________________        State:   ________       Zip:________

Phone:  ______________________________

E-mail:  __________________________________________________________

Chapter/No./City/State:  ________________________________________________________

Ancestor:  ___________________________________________________________________

Service:  ____________________________________________________________________

(As listed on Membership certificate)  Please provide page 1 & 4 of approved application.  

Place of Burial:  ______________________________________________________________
                       (Cemetery                                City                         County                   State                               

Type of Marker: ______________________________________________________________

I certify that the above information is true and correct; that the applicant is a member in good standing of the
Chapter named above, and that the applicant is the Great Great Great Granddaughter of the soldier named
herein.

Signature of Applicant:  ____________________________________________  Date:________________  

Fees:  Membership dues and application: $5.00 ($2.00-General; $3.00-Division)
Yearly dues thereafter: $5.00 (payable prior to Aug 31st of each year to Treasurer SC GGG GD Club)
Make checks payable to: Treasurer SC GGG GD Club and mail to Julia Barnes, 710 Due West Road, Honea
Path, SC  29654-8722.  juliabarnes@charter.net.  
More information will be coming about the pin as soon as it is available from General.  Quotes are in the
process and a manufacturer will be chosen as soon as possible.