For Membership into the

(please print and mail with membership fee)

Membership includes:  1.  Handsome Certificate suitable for framing;  2.  Calendar year's subscription to "Confederate Veteran Magazine";  3.  Subscription to "The Fort Brooke Record";  4.  Camaraderie with a unique and honorable group of men in the West Central Florida area.

I  (print)_____________________________________________________ who resides at the following address: 

Street __________________________________________________

City ________________________________     State_____________   

 Zip_______ Phone_________________________________

do petition the officers of the John T. Lesley Camp 1282, located in Tampa, Florida, for membership into the Confederate Legion of the Lesley Camp. I understand that membership in the Confederate Legion does not make me a member of the Sons of Confederate Veterans but that I will have all rights of membership other than participation in the constitutional processes of the Camp, the Division, or the Confederation. Enclosed please find a check for *__________, made out to the John T. Lesley Camp, for one year’s membership.

Dated___________________________________________

Signed__________________________________________

*Include the following membership fee if mailed in:
November - $35 - 1 year + 2 mos. membership
December -  $32.50 - 1 year + 1 mos. membership
January - $30 - 1 year's membership
February - $27.50 - 11 mos. membership
March - $25 - 10 mos. membership
April - $22.50 - 9 mos. membership
May - $20 - 8 mos. membership
June - $17.50 - 7 mos. membership
July - $15 - 6 mos. membership
August - $12.50 - 5 mos. membership
September - $40 - 1 year + 4 mos. membership
October - $37.50 - 1 year + 3 mos. membership

Mail to:

Adjutant Dwight Tetrick
Capt. John T. Lesley Camp #1282, SCV
19126 Amelia Circle
Lutz, Florida 33558