Heritage Specialties

Purple Heart and Badge of the Seven Confederate Knights Certificate.

A custom designed certificate suitable for framing.

Extra certificates may be purchased for $10 each.

     Please complete all appropriate boxes and press the SUBMIT     button below.

 

YOUR Name "first, middle, last "

* Required fields

First*

middle or initial

Last *

 

Your Street Address *

City *

State *

Zip *

Your Phone Number

Your Email address *

ANCESTORS Name " first, middle, last "

First *

middle or initial

Last *

Rank *

Unit *

Date Enlisted                                     Location

 

Date Wounded                                  Location

 

Date Killed In Action                         Location

 

Date Died                                         Location

 

Date Deserted                                   Location

 

Date Captured                                   Location

 

Date Paroled                                     Location

 

Date Imprisoned                                Location

 

On Last Roll?


Yes   No

Relationship

Other Remarks

Print press the button below after all boxes are completed.  Please contact us with any questions.                    

                                           

 

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To contact us:

Email: heritagespec@earthlink.net

Phone: 863/285-8800
Fax: 863/285-1220