Sons of Confederate Veterans

2012 Georgia Division

115th Reunion
Bainbridge, Georgia
June 8th 10th

Ancestor Memorial Ad for 2012 Reunion Program

Please fill in all information lines for each Ancestor Ad :
Rank/ Name__________________________________/________________________________________________
Company /Regiment_____________________________________/______________________________________
Service Branch_________________________________________________________________________________
Ancestor of___________________________________________________________________________________
Rank/ Name__________________________________/________________________________________________
Company /Regiment_____________________________________/______________________________________
Service Branch_________________________________________________________________________________
Ancestor of___________________________________________________________________________________
Rank/ Name__________________________________/________________________________________________
Company /Regiment_____________________________________/______________________________________
Service Branch_________________________________________________________________________________
Ancestor of___________________________________________________________________________________

Ancestor Memorials (four lines) per ad

$10.00 x _____
Total Enclosed:

$_____________
$_____________

th

The deadline is April 15 , 2012.

All ads are subject to approval by the Decatur Grays Reunion Committee.
Purchasers Information
Name: _______________________________________________________________________________
Address: ______________________________________________________________________________________
City/ State/ Zip: ________________________________________/ ______________/ _______________________
Telephone: ____________________________________________ Cell: ___________________________________
Email: ____________________________________________Web site address:_____________________________
Send this form and payment to:
Decatur Grays Georgia Division Reunion 2012
PO Box 1184
Bainbridge, GA 39818

For more information contact John Fisher at: decaturgrays@ymail.com or (229)246-9739

www.decaturgrays.com