SMDPA - SMDPA Proposal for Membership

Join

Quick Links

SMDPA Proposal for Membership

This is an on-line proposal submission form.

* Date of Application

Prefix Mr., Mrs., Ms., Dr., Rev., Other

* First Name

* Last Name

Suffix Sr., Jr., III, MD, PhD., Other

* Date of Birth

Address

City

State

Zip

* Primary Email

Alternate Email

Home Phone

Cell Phone

Mayflower Lineage

Please list the Line Carrier (Son/ Daughter) and the Spouse of each. Please note that your name should be last
(ie) Son: John Quincy Adams; Spouse: Louisa Adams

Name the Line Carrier and Spouse of each Please use the SMDPA Mayflower Introductory/Basic form.

Please complete and submit the SMDPA Proposal form first. The SMDPA Mayflower Introductory/Basic form may be sent separately to smdpa-historian via email and the form is located here.

Marital Status (if applicable)

Full Name of Spouse

Full Maiden Name If different from above

SUPPLEMENTAL / TRANSFER MEMBER INFORMATION

* Is this inquiry a Supplemental?

* Are you a transferring member of another State Society?

Name of State

Your GSMD Member #

Your State Member #

Membership Inquiry

* Do you have a relative in any state Mayflower Society?

Full Name of Relative if answered Yes above

Relationship to you

Relative’s GSMD Member #

Relative’s State Member #

Membership Category

* Indicate the category you are seeking

How did you learn of the Society? (General Society, Member, Sail 1620 web site, Brochure, press/publicity, other)