SCRUGGS
FAMILY ASSOCIATION
MEMBERSHIP APPLICATION
Name_________________________________________________
Address______________________________________________
(Please
include your plus 4 zip code)
Phone__________________________Fax___________________
E-Mail________________________________________________
NAME, RESIDENCE
AND DATE OF EARLIEST PROVEN
SCRUGGS
ANCESTOR
Name_________________________________________________
Residence_____________________________________________
Date__________________________________________________
Comments____________________________________________
______________________________________________________
______________________________________________________
PLEASE
RETURN CHARTS AND CHECK TO:
William N. Scruggs
1137 Los Serenos Dr.
wnscruggs@sbcglobal.net