ࡱ> B` 1bjbjss 8N[ <TTTTt ...8.0|ld1IIII?KvZb2}4}4}4}4}4}4}$h#X}1gK"?KggX}TTIIz|z|z|gHT8II2}z|g2}z|z|z| IX1 d .6iz||l0z|%k%|%|@uf0f"z|ff ufufufX}X}d|ufufufgggglllD.lll.$TTTTTT  _________________ APPLICATION TYPE:  FORMCHECKBOX  MEMORIAL MEMBERSHIP  FORMCHECKBOX  REGULAR MEMBERSHIP  FORMCHECKBOX  JUNIOR MEMBERSHIP  FORMCHECKBOX  YOUTH REGISTRANT  FORMCHECKBOX  SUPPLEMENTAL  EMBED Word.Picture.8  National number  FORMTEXT       State number  FORMTEXT        N/A Chapter, the District of Columbia State Society NATIONAL SOCIETY SONS OF THE AMERICAN REVOLUTION I hereby apply for membership in this Society by the right of bloodline descent from:  FORMTEXT Text must not wrap; F1 for help. Gen.# FORMTEXT    who assisted in establishing American Independence while acting in the capacity of:  FORMTEXT Text must not wrap; F1 for help. NAME OF APPLICANT  FORMTEXT        FORMTEXT        FORMTEXT       Age  FORMTEXT     (First) (Middle) (Last) Street, R. D. or P.O. Box  FORMTEXT       City  FORMTEXT       State  FORMTEXT       Zip Code  FORMTEXT       Phone  FORMTEXT       Having living or deceased children by bloodline of applicant and not by adoption, by my wife as listed: Child Name Relationship Wife# Date of Birth Place of Birth State  FORMTEXT        FORMTEXT        FORMTEXT     FORMTEXT        FORMTEXT        FORMTEXT      FORMTEXT        FORMTEXT        FORMTEXT     FORMTEXT        FORMTEXT        FORMTEXT      FORMTEXT        FORMTEXT        FORMTEXT     FORMTEXT        FORMTEXT        FORMTEXT      FORMTEXT        FORMTEXT        FORMTEXT     FORMTEXT        FORMTEXT        FORMTEXT      FORMTEXT        FORMTEXT        FORMTEXT     FORMTEXT        FORMTEXT        FORMTEXT      FORMTEXT        FORMTEXT        FORMTEXT     FORMTEXT        FORMTEXT        FORMTEXT     STATEMENT OF BLOODLINE TO PATRIOT ANCESTOR (Give all names, dates, and places known. Show dates as day, month, and year e.g. 01 Jan 1900) DATE CITY/COUNTY STATE 1. I am  FORMTEXT       born  FORMTEXT        FORMTEXT        FORMTEXT     and my  FORMTEXT    wife  FORMTEXT       born  FORMTEXT        FORMTEXT        FORMTEXT     NSDAR#  FORMTEXT       died  FORMTEXT        FORMTEXT        FORMTEXT     (If Remarried) married  FORMTEXT        FORMTEXT        FORMTEXT     my  FORMTEXT    wife  FORMTEXT       born  FORMTEXT        FORMTEXT        FORMTEXT     NSDAR#  FORMTEXT       died  FORMTEXT        FORMTEXT        FORMTEXT     married  FORMTEXT        FORMTEXT        FORMTEXT     _________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ 2. I am the son of  FORMTEXT       born  FORMTEXT        FORMTEXT        FORMTEXT     NSSAR#  FORMTEXT       died  FORMTEXT        FORMTEXT        FORMTEXT     and his  FORMTEXT    wife  FORMTEXT       born  FORMTEXT        FORMTEXT        FORMTEXT     NSDAR#  FORMTEXT       died  FORMTEXT        FORMTEXT        FORMTEXT     Who is the son  FORMCHECKBOX  /daughter  FORMCHECKBOX  of married  FORMTEXT        FORMTEXT        FORMTEXT     _________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ 3. Grandson of  FORMTEXT       born  FORMTEXT        FORMTEXT        FORMTEXT     NSSAR#  FORMTEXT       died  FORMTEXT        FORMTEXT        FORMTEXT     and his  FORMTEXT    wife  FORMTEXT       born  FORMTEXT        FORMTEXT        FORMTEXT     NSDAR#  FORMTEXT       died  FORMTEXT        FORMTEXT        FORMTEXT     Who is the son  FORMCHECKBOX  /daughter  FORMCHECKBOX  of married  FORMTEXT        FORMTEXT        FORMTEXT     _________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ 4. Great-Grandson of  FORMTEXT       born  FORMTEXT        FORMTEXT        FORMTEXT     NSSAR#  FORMTEXT       died  FORMTEXT        FORMTEXT        FORMTEXT     and his  FORMTEXT    wife  FORMTEXT       born  FORMTEXT        FORMTEXT        FORMTEXT     NSDAR#  FORMTEXT       died  FORMTEXT        FORMTEXT        FORMTEXT     Who is the son  FORMCHECKBOX  /daughter  FORMCHECKBOX  of married  FORMTEXT        FORMTEXT        FORMTEXT     _________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ 5. Great2Grandson of  FORMTEXT       born  FORMTEXT        FORMTEXT        FORMTEXT     NSSAR#  FORMTEXT       died  FORMTEXT        FORMTEXT        FORMTEXT     and his  FORMTEXT    wife  FORMTEXT       born  FORMTEXT        FORMTEXT        FORMTEXT     NSDAR#  FORMTEXT       died  FORMTEXT        FORMTEXT        FORMTEXT     Who is the son  FORMCHECKBOX  /daughter  FORMCHECKBOX  of married  FORMTEXT        FORMTEXT        FORMTEXT     _________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ 6. Great3Grandson of  FORMTEXT       born  FORMTEXT        FORMTEXT        FORMTEXT     NSSAR#  FORMTEXT       died  FORMTEXT        FORMTEXT        FORMTEXT     and his  FORMTEXT    wife  FORMTEXT       born  FORMTEXT        FORMTEXT        FORMTEXT     NSDAR#  FORMTEXT       died  FORMTEXT        FORMTEXT        FORMTEXT     Who is the son  FORMCHECKBOX  /daughter  FORMCHECKBOX  of married  FORMTEXT        FORMTEXT        FORMTEXT     _________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ 7. Great4Grandson of  FORMTEXT       born  FORMTEXT        FORMTEXT        FORMTEXT     died  FORMTEXT        FORMTEXT        FORMTEXT     and his  FORMTEXT    wife  FORMTEXT       born  FORMTEXT        FORMTEXT        FORMTEXT     died  FORMTEXT        FORMTEXT        FORMTEXT     Who is the son  FORMCHECKBOX  /daughter  FORMCHECKBOX  of married  FORMTEXT        FORMTEXT        FORMTEXT     _________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ 8. Great5Grandson of  FORMTEXT       born  FORMTEXT        FORMTEXT        FORMTEXT     died  FORMTEXT        FORMTEXT        FORMTEXT     and his  FORMTEXT    wife  FORMTEXT       born  FORMTEXT        FORMTEXT        FORMTEXT     died  FORMTEXT        FORMTEXT        FORMTEXT     Who is the son  FORMCHECKBOX  /daughter  FORMCHECKBOX  of married  FORMTEXT        FORMTEXT        FORMTEXT     _________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ 9. Great6Grandson of  FORMTEXT       born  FORMTEXT        FORMTEXT        FORMTEXT     died  FORMTEXT        FORMTEXT        FORMTEXT     and his  FORMTEXT    wife  FORMTEXT       born  FORMTEXT        FORMTEXT        FORMTEXT     died  FORMTEXT        FORMTEXT        FORMTEXT     Who is the son  FORMCHECKBOX  /daughter  FORMCHECKBOX  of married  FORMTEXT        FORMTEXT        FORMTEXT     ________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________------------------------- 10. Great7Grandson of  FORMTEXT       born  FORMTEXT        FORMTEXT        FORMTEXT     died  FORMTEXT        FORMTEXT        FORMTEXT     and his  FORMTEXT    wife  FORMTEXT       born  FORMTEXT        FORMTEXT        FORMTEXT     died  FORMTEXT        FORMTEXT        FORMTEXT     Who is the son  FORMCHECKBOX  /daughter  FORMCHECKBOX  of married  FORMTEXT        FORMTEXT        FORMTEXT     _________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ 11. Great8Grandson of  FORMTEXT       born  FORMTEXT        FORMTEXT        FORMTEXT     died  FORMTEXT        FORMTEXT        FORMTEXT     and his  FORMTEXT    wife  FORMTEXT       born  FORMTEXT        FORMTEXT        FORMTEXT     died  FORMTEXT        FORMTEXT        FORMTEXT     Who is the son  FORMCHECKBOX  /daughter  FORMCHECKBOX  of married  FORMTEXT        FORMTEXT        FORMTEXT     _________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ 12. 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hoCJjhoCJUjhX3hX3CJU&]_`abbceB |)@ |) r'€@ rR&|)€ hN rR&|)@€ hrR&|)@€ hrR&|)@€  rR&|)€ hrR&|)@€ hN r%(@€2`4`>`@`B`D`X`Z`\`f`h`j`l``````````````````````aaaaa,a.aBaDaFaJaLaZa\apaָ֚֩֋|jho5CJUjho5CJUj,ho5CJUjho5CJUj<ho5CJUjĜho5CJU ho5CJ hoCJ!jhX35CJUmHnHujho5CJU0parata~aaaaaaaaaaaaaaaaaaaaaabbbb(b*b,b6b8b:b@BDXZ\fhjlν߮ߟߐ߁rjvho5CJUjho5CJUjho5CJUjho5CJUjho5CJU!jhX35CJUmHnHuUjho5CJU ho5CJjho5CJU hoCJ hoCJH*,      born  FORMTEXT        FORMTEXT        FORMTEXT     died  FORMTEXT        FORMTEXT        FORMTEXT     and his  FORMTEXT    wife  FORMTEXT       born  FORMTEXT        FORMTEXT        FORMTEXT     died  FORMTEXT        FORMTEXT        FORMTEXT     married  FORMTEXT        FORMTEXT        FORMTEXT     ____________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ REVOLUTIONARY WAR ANCESTOR   Generation  FORMTEXT    BURIED in the  FORMTEXT       Cemetery at  FORMTEXT       REFERENCES: Proof is needed only for individuals in the bloodline. Furnish a copy of each piece of evidence such as: birth certificate; marriage, baptismal, or cemetery record with parents names; census 1850 or later; explicit Bible record; court docu- ment; title page and pertinent pages of annotated publications; DAR record copy. My Gen. (Birth Certificate or equal showing parents)  FORMTEXT Text must not wrap; F1 for help.  FORMTEXT Text must not wrap; F1 for help. _________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ 2nd Gen.  FORMTEXT        FORMTEXT       _________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ 3rd Gen.  FORMTEXT        FORMTEXT       _________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ 4th Gen.  FORMTEXT        FORMTEXT       _________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ 5th Gen.  FORMTEXT        FORMTEXT       _________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ 6th Gen.  FORMTEXT        FORMTEXT       _________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ 7th Gen.  FORMTEXT        FORMTEXT       _________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ 8th Gen.  FORMTEXT        FORMTEXT       _________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ 9th Gen.  FORMTEXT        FORMTEXT       _______________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________-_________________ 10th Gen.  FORMTEXT        FORMTEXT       _________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ 11th Gen.  FORMTEXT        FORMTEXT       _________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ 12th Gen.  FORMTEXT        FORMTEXT       _________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________________ REFERENCES to Ancestor s Revolutionary War Service  FORMTEXT        FORMTEXT        FORMTEXT        FORMTEXT       I,  FORMTEXT       , the applicant, swear and certify that I have examined this completed application and its proofs (documentation) and the facts and statements herein are true and correct to the best of my knowledge and belief. Signature of Applicant Date __________________, _______ Occupation  FORMTEXT       Recommended by the undersigned members State Registrar ______________________________ Sponsor Application verified Name  FORMTEXT       and approved Date __________________, _______ Street  FORMTEXT       P.O. & Zip  FORMTEXT       State Secretary ______________________________ Accepted by the State Board Signed _________________________________________ of Management Date __________________, _______ NSSAR#  FORMTEXT       Forwarded to National Date __________________, _______ Co-Sponsor (When Required) Name  FORMTEXT       Received at National Hdqrs. Date __________________, _______ Registered by NSSAR Date __________________, _______ Signed _________________________________________ Certificate Dated. 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