ORDER OF CONFEDERATE ROSE
Membership Application
APPLICANT Name: _________________________________________________
Street or Box: _________________________________
City, State, Zip:
_________________________________
Home Phone:
______________________
Cell Phone / Pager, Etc.
______________________________
e-mail:
____________@___________________
Date Of Birth: _________________________________
Signature: ______________________________________________________________
REFERRAL
(signature of SCV member-in-good-standing):
General John Bell Hood SCV Camp 1208
562.947.1554
Signature: _________________________________________
RECOMMENDATION (signature of a member of
OCR):
Sandra Ashdown-Turner
Southern California Chapter OCR President
562.695.6687
Signature:
______________________________________________
Date of Submission: _________________________
Make $20 check payable to OCR and mail to
Adjutant
16302 Shady