Clan Sinclair Association, Inc., (U.S.A.)
The Right Honorable Malcolm Sinclair, The Earl of Caithness
Hereditary Chief of Clan Sinclair

Donald L. Sinclair
President
567 Pitts Bayshore Drive
Freeport, FL 32439
850-638-7574
dons3@mindspring.com
Mary Jane Selver
Secretary/Treasurer
89 Sentry Way
Merrimack, NH 03054
603-423-5996
selvermj@aol.com

Web Site: http://www.clansinclairusa.org

Membership Classifications:
Family Membership (includes spouse and all minor children)........................................$20.00/year
Sponsor Membership...............................................................................................................$35.00/year

New Member                             Renewal                           

PLEASE PRINT

Last Name: ____________________ First: ________________ Middle:______  Birth Date:__________
Spouse Name:__________________ First:_________________ Middle:______  Birth Date:__________
MINOR CHILDREN  (Living at Home):

Name:_________________  Birth Date:__________    Name:_______________ Birth Date:__________
Name:_________________  Birth Date:__________    Name:_______________  Birth Date:__________

ADDRESS:
Street or P. O. Box   _______________________________________________________________
City:  __________________________ State/Province:_______________ Postal Code:___________ 
Telephone #______________________  E-mail Address:__________________________________
Occupation:_______________________________   Interests:______________________________

CLAN CONNECTION: From whom in your family do you inherit the name Sinclair or Sept name:
(Refer to the Sept List on the Clan Sinclair USA Web Site noted above)

Father                                   Paternal Grandfather                                Paternal Grandmother  
Mother                                  Maternal Grandfather                               Maternal Grandmother  
                    
Other (Explain)_____________________________________________________________________
 


FOR OFFICE USE ONLY:     Date Rec'd ________ Check Date ________ Email Sent ________
Card #__________         Expiration Date:_____________       Check #____________
Recorded In: Clan DB ______     MemDB ________     P&L_______    Card Sent_______  Deposited______                        

 

 

 

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