Marker Dedication Request Form

Just complete this form. Click on Submit when ready to send.

Name of the Confederate Veteran:
Rank Held (If known)
Unit Served In: (eg. 37th Virginia)
Contact Name
Contact Address
Contact Phone
Contact E-mail

If you can determine the exact GPS Location of the grave site it will make it easier for participants to locate.

GPS Latitude
GPS Longitude

A flag presentation will be part of the proceedings. Please decide who will
receive the flag for the family and an alternate should the desired person be unable to attend.

Flag Recipient
Alternate Recipient

Marker Dedication Request Form

Name of the Confederate Veteran:

Rank Held (If known)

Unit Served In: (eg. 37th Virginia)

Contact Name

Contact Address

Contact Phone

Contact E-mail

GPS Latitude

GPS Longitude

Flag Recipient

Alternate Recipient

Directions to grave site.