Member # ______

Founded 6February 2013

Application for Membership

I, the undersigned, apply for Life Membership in this order by right of lineal descent from

(name as it will appear on the certificate)

born in: on or about:

settled in the county of: in Virginia on or about:

died in: on or about:

Name of Applicant:

Street:

City: State: Zip + 4:

Telephone: Email:

Name as you would like it on the Certificate:

SDVAFF Member Sponsors

and

Applicant’s Signature: ______Date: ______

Examined Approved:______, Genealogist Date:______

All Generations MUST be proven from the applicant to the Virginia ancestor.

Applicant:

1.

Born at: on:

Married (1) on: at:

To:

Born at: on:

Died or divorced at: on:

Married (2) on: at:

To:

Born at: on:

Died or divorced at: on:

Proofs:

The said was the child of:

Born at: on:

Died at: on:

Married on: at:

To:

Born at: on:

Diedat: on:

Proofs:

The said was the child of:

Born at: on:

Died at: on:

Married on: at:

To:

Born at: on:

Diedat: on:

Proofs:

The said was the child of:

Born at: on:

Died at: on:

Married on: at:

To:

Born at: on:

Diedat: on:

Proofs:

The said was the child of:

Born at: on:

Died at: on:

Married on: at:

To:

Born at: on:

Diedat: on:

Proofs:

The said was the child of:

Born at: on:

Died at: on:

Married on: at:

To:

Born at: on:

Diedat: on:

Proofs:

The said was the child of:

Born at: on:

Died at: on:

Married on: at:

To:

Born at: on:

Diedat: on:

Proofs:

The said was the child of:

Born at: on:

Died at: on:

Married on: at:

To:

Born at: on:

Diedat: on:

Proofs:

The said was the child of:

Born at: on:

Died at: on:

Married on: at:

To:

Born at: on:

Diedat: on:

Proofs:

The said was the child of:

Born at: on:

Died at: on:

Married on: at:

To:

Born at: on:

Diedat: on:

Proofs:

The said was the child of:

Born at: on:

Died at: on:

Married on: at:

To:

Born at: on:

Diedat: on:

Proofs:

The said was the child of:

Born at: on:

Died at: on:

Married on: at:

To:

Born at: on:

Diedat: on:

Proofs:

The said was the child of:

Born at: on:

Died at: on:

Married on: at:

To:

Born at: on:

Diedat: on:

Proofs:

The said was the child of:

Born at: on:

Died at: on:

Married on: at:

To:

Born at: on:

Diedat: on:

Proofs:

The said was the child of:

Born at: on:

Died at: on:

Married on: at:

To:

Born at: on:

Diedat: on:

Proofs:

The said was the child of:

Born at: on:

Died at: on:

Married on: at:

To:

Born at: on:

Diedat: on:

Proofs:

My Virginia ancestor was married to

(1) on in

(2) on in

(3) on in

Proof:

Children of my Virginia ancestor (by each marriage, if applicable)

marriage born married to

marriage born married to

marriage born married to

marriage born married to

marriage born married to

marriage born married to

marriage born married to

marriage born married to

marriage born married to

marriage born married to

Proof:

In the event that an SDVAFF Lineage Book is published some time in the future, I

do

do not

give my permission to have my lineage included.

1

KEM

2013