Please Complete Applicable Sections and Submit (items in red are required)

Select your Chapter: none Andrew Crockett Andrew Jackson Anthony Bledsoe Benjamin Cleveland Christopher Strong Cumberland Gap Hiwassee Isaac Shelby Jackson Purchase James Madison John Sevier Joseph Greer Kings Mountain State of Franklin Stephen Holston Stones River Thomas Kilgore Tombigbee Valentine Sevier Watauga William Quarles

 Name (first last):     E-Mail Address: 

National #:     

Speaking Engagements

Compatriot Presenter Name (first last):     Date (MM/DD/YY):  

 Presented at:

Compatriot Wearing Uniform:  Yes No             18th Century Clothing:  Yes No

Support of CAR and DAR (attendance at meeting/events with DAR or SAR present, or donations to CAR)

Compatriot Name (first last):     Date (MM/DD/YY):  

Compatriot Wearing Uniform:  Yes No             18th Century Clothing:  Yes No

Donation Amount: $

Special Observances or Ceremonies (including Washington’s Birthday, Patriot’s Day, Memorial Day, Flag Day, Fourth of July, Constitution Week, Yorktown Day, Veteran’s Day, Wreaths Across America, Patriotic Sites)

Compatriot Name (first last):     Date (MM/DD/YY):  

Compatriot Wearing Uniform:  Yes No             18th Century Clothing:  Yes No

Compatriot Presenting Wreath at Event:  Yes No            

Event Type:  none Chapter Event State Event National Event

Revolutionary War Grave Markings

Patriot Grave Marked:     Date (MM/DD/YY):  

Did YOUR Chapter Sponsor this marking Yes No , Or were you attending another Yes No 

Compatriot Wearing Uniform:  Yes No             18th Century Clothing:  Yes No

Did you present a wreath:   Yes No   

Flag Placement on Veteran's Grave (that occurs in conjunction with a national holiday, or other commemorative event)

Patriot Grave Marked:     Date (MM/DD/YY):     # of Flags Placed:   

Attendance at a Compatriot Grave Marking

Compatriot Grave Marked:     Date (MM/DD/YY):  

Compatriot Attending (first last):     Compatriot Presenting Wreath at Event: Yes No   

Was this the initial marking for the grave: Yes No   

Compatriot Wearing Uniform:  Yes No             18th Century Clothing:  Yes No

Attendance at State, District, & National Meetings

Compatriot Attending Meeting (first last):     Date (MM/DD/YY):  

Event Type:  none State Event District Event National Event

Compatriot Wearing Uniform:  Yes No             18th Century Clothing:  Yes No

Compatriot Serving at the NSSAR

National Committee Chairman, Co-Chairman, Vice Chairman

Name:  Committee: Role:

A National Committee Member who served and ATTENDED the meeting at a NSSAR Leadership Meeting or Congress as verified by the Committee Chairman’s published Report. (excluding Chairman, Co-Chairman, and Vice Chairman)

Name:  Committee: Date (MM/DD/YY):  

A member who served as Vice President General

Name: 

A member who served as National Trustee, Alternate National Trustee, or General Officer, other than Vice President General.

Name:  Role:

A member who served on the Executive Committee

Name:  Role:

Contributions to the SAR

Name:    has contributed $ to the:

none George Washington Endowment Fund Friends of the Library Center for Advancing America's Heritage Other

Complete if Other:

Use this Section to report items which are not listed above:

Upon completion of the Form above, you may chose:

•  The "Submit" button below to submit the data to the selected Chapter President and TNSSAR Americanism chairman

•  or, the "Clear Form" to start over again (warning, all data will be lost)