Ben Caudill Camp #1629
Civil War Memorial Historical Monument
  Data Sheet 

Contact Information of Person Purchasing Name
Purchase Price: $20.00

Name: _______________________________________________________

Mailing Address________________________________________________________

Email__________________________________________________________________

Phone_________________________________________________________________

Date Money Received/Check #/Money Order/Cash Receipt______________________

Date Ordered_____________________________________________________

Family notified by: phone____email_____letter____in person____

Soldier’s Name/Rank/Unit/Comments_____________________________________________________________

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(Pictures of the 8’8” by 10’ Historical Marker Located at Pound Gap (Rt. 23) on Va.-Ky. border)


(Send check to: P.O. Box 1102, 71 Highway 119, Whitesburg, KY 41858 )