Your full name: (As you want it to appear on your Certificate)
Your complete street address: (Where you want your pin mailed)
Your telephone number:
Your e-mail address:
How did you hear about the Clara Barton Pin? (select one) Saw it on your Web Site The Banner Magazine Internet search Saw it announced on Facebook Anouncement at a Camp meeting Email from a friend
Comments:
This appreciation award is proudly presented to: (Full Name of Recipient)
In Honor Of: (List her service, achievement, or other reason for the award)
By: (List the name and/or organization who is presenting the award)
Certificate Signers Title: (optional)
Designed and Maintained for the Department of Texas and Louisiana, Sons of Union Veterans of the Civil War by: Copyright © 2021 - 2025, Department of Texas and Louisiana, Sons of Union Veterans of the Civil War All Rights Reserved. Limited use rights may be granted by written or electronic permission.
