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APPLICATION FOR MEMBERSHIP.
ISSUED BY NATIONAL 80CIBTY, D. A. *.
To be mide in duplicate and forwarded to the Registrar General of the National Society, 902 F Street, Washington, D. C When approved by the National Officers, one copy will be returned to the Registrar of the Chapter.
, 189..
TO THE BOARD OF MANAGERS OF THE
DAUGHTERS OF THE AMERICAN REVOLUTION.
I,
being of the age of eighteen veare and
upwards, hereby apply for membership in this Society by right of lineal descent in the following line from '
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^ ^	?.on the	day of	, 17 ^ ^ ?
f	i^Z-T  .on the	e?-	day	of	, \t^S
and who served in the war of the Revolution.	,	f	j	?
of	<4^Cou	ntv	of	'	-5
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who was bom in and died in
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I was born in the
State of J&
?	I	am	the	daughter	of
granddaughter of *	....L/	?	and
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great-granddaughter of^ great-great-granddaughter of great-great-great-granddaughter of (/ great-great-great-great-granddaughter of
	
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, his wife, and j ? and |
and he, the said
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his wife I
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establishing A meric^j* Independence, while acting in the capacity of
Nominated and recommended by the undersigned, a member of the Society:
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Signature of applicant.
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R?sidence.
/t7__________________________________________________________
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