Junior Member Application

A child between the ages of birth through age eighteen may become a Junior Member by being sponsored by a GSMD relative in the direct line. Lineage does not have to be proven for the Junior; however, the sponsor must have a proven lineage and fill out the application as the sponsor. The sponsor must include their GSMD and state number along with the sponsors ancestor.

Make checks payable to: The Georgia Mayflower Society for the amount of $40.00. Please write the name of the Junior Member in the memo line with the term Junior Member.

Send check and application to: Peggy McCall, Georgia Mayflower Education Chair

165 Trails End Summit

Ellijay, GA 30540

(PRINT CLEARLY)

NAME OF SPONSOR: _______________________________________________________________________

ADDRESS: _____________________________________________________________
_____________________________________________________________________
____________________________________________________________________

STATE and STATE NUMBER: _____________________________ GENERAL NUMBER: ___________________

SPONSORS TELEPHONE NUMBER: _____________________________________________

SPONSORS EMAIL ADDRESS: ___________________________________________________________________

NAME OF JUNIOR MEMBER: _____________________________________________________________________

CIRCLE ONE: MALE FEMALE

ADDRESS OF JUNIOR MEMBER: __________________________________________________________________

_________________________________________________________________________

_______________________ EMAIL ADDRESS OF JUNIOR MEMBER OR THEIR PARENT: _________________________________________

BIRTHDATE OF JUNIOR: (month, day, year) _________________________________________________________

GRANDFATHERS NAME IN MAYFLOWER LINEAGE: _______________________________________________

GRANDFATHERS BIRTHDATE AND PLACE: _______________________________________________________

GRANDMOTHERS NAME IN MAYFLOWER LINEAGE: ______________________________________________

GRANDMOTHERS BIRTHDATE AND PLACE: ______________________________________________________

GRANDPARENTS MARRIAGE PLACE: ____________________________________________________________

GRANDPARENTS MARRIAGE DATE: _____________________________________________________________

PROVEN MAYFLOWER PASSENGER(S): ______________________________________________________________________

SPONSORS SIGNATURE: (I hereby confirm the above to be correct.)

________________________________________________________

Sponsor, Please check one of the following.

□ This is a gift. Please send your welcome package and membership pin to me as the sponsor.

□ Please send the welcome package and membership pin directly to my Junior Member.