DUVCW Membership App (page2/3

1 APPLICATION FOR Membership . __ New Application or __ Supplemental ___ National Hdqtrs. Original Copy ___ National Registrar Copy ___ Department Copy ___ Tent Copy PLEASE PRINT OR TYPE. Application of _____. First Middle Maiden Last Name Check one ___Miss ___Mrs. ___Ms. or ___Dr. Address _____. _____ Zip code _____- _____. Phone _____-_____-_____ Email _____. Recommended by _____. Department of _____. Tent Number _____ Name _____ City _____. WAR RECORD. Direct Descendent of _____. Relationship _____. Enlisted _____ as _____. Date Rank In Company _____ Regiment No. _____ State _____ Regular Army _____. Infantry _____ Cavalry _____ Artillery (Heavy/Light) _____ Other _____.

2 Navy _____ Ship _____ Marines _____ Revenue Cutter Service _____. Service Ended _____. Date Rank By reason of _____. Further service, if any _____. _____. Grand Army of the Republic Membership , if any _____. _____. Post _____City _____State _____. This document is the property of the Daughters of Union Veterans of the Civil War, 1861-1865, Springfield, Illinois Revised May 2014. PLEASE COMPLETE. Give all dates per example, 03 Jun 2014. Include wife/wives' maiden name(s). DATE LOCATION & STATE. ( 1) I am _____ born _____ _____. and married _____ born _____ _____. died _____ _____. married _____ _____. Documentation: _____. ( 2) daughter of _____ born _____ _____. died _____ _____.

3 And _____ born _____ _____. died _____ _____. married _____ _____. Documentation: _____. ( 3) granddaughter of _____ born _____ _____. died _____ _____. and _____ born _____ _____. died _____ _____. married _____ _____. Documentation: _____. ( 4) Great-granddaughter of _____ born _____ _____. died _____ _____. and _____ born _____ _____. died _____ _____. married _____ _____. Documentation: _____. ( 5) 2nd G-granddaughter of _____ born _____ _____. died _____ _____. and _____ born _____ _____. died _____ _____. married _____ _____. Documentation: _____. ( 6) 3rd G-granddaughter of_____ born _____ _____. died _____ _____. and _____ born _____ _____. died _____ _____. married _____ _____.

4 Documentation: _____. This document is the property of the Daughters of Union Veterans of the Civil War, 1861-1865, Springfield, Illinois Revised May 2014. DATE LOCATION & STATE. ( 7) 4th G-granddaughter of _____ born _____ _____. died _____ _____. and _____ born _____ _____. died _____ _____. married _____ _____. Documentation: _____. ( 8) 5th G-granddaughter of _____ born _____ _____. died _____ _____. and _____ born _____ _____. died _____ _____. married _____ _____. Documentation: _____. ( 9) 6th G-granddaughter of _____ born _____ _____. died _____ _____. and _____ born _____ _____. died _____ _____. married _____ _____. Documentation: _____. (10) 7th G-granddaughter of _____ born _____ _____.

5 Died _____ _____. and _____ born _____ _____. died _____ _____. married _____ _____. Documentation: _____. (11) 8th G-granddaughter of _____ born _____ _____. died _____ _____. and _____ born _____ _____. died _____ _____. married _____ _____. Documentation: _____. (12) 9th G-granddaughter of _____ born _____ _____. died _____ _____. and _____ born _____ _____. died _____ _____. married _____ _____. Documentation: _____. _____ _____. Applicant Signature Date This document is the property of the Daughters of Union Veterans of the Civil War, 1861-1865, Springfield, Illinois Revised May 2014. OATH FOR Membership . I, _____, do most faithfully promise on my honor as a daughter of a Union Veteran of the Civil War; that I will do all in my power to cooperate in the work of this order, promote the Civil War heritage of which we are so proud, and will remain loyal to my country and flag.

6 _____ _____. Applicant Signature Date ---------------------------------------- --------------------------- FOR OFFICE USE ONLY. Eligibility Verification Committee of three appointed by President: Print Name Written Signature _____ _____. _____ _____. _____ _____. Approved: _____ _____. President Date Secretary Date Application with fee: Initiation _____ Membership effective _____. Transfer _____ Date Reinstatement _____. Supplemental _____. Member at Large _____ Membership effective _____. Transfer _____ Date Report of Committee _____ Applicant Elected _____. Date Date Notified by Secretary _____ Admitted to Membership _____. Date Date Dropped _____ Reinstated _____. Date Date Transferred Out _____ To Tent _____.

7 Date Date Honorably Discharged _____ Died _____. Date Date This document is the property of the Daughters of Union Veterans of the Civil War, 1861-1865, Springfield, Illinois Revised May 2014.