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WAR HISTORY COMMISSION

STATE OF VIRGINIA

MILITARY SERVICE RECORD

Name in full

(family name): Clark

(first name): Charles

(middle name): Pleasant

Date of birth

(month): June

(day): 3rd

(year): 1893

Place of Birth

(town): The Hollow

(county): Patrick

(state): Virginia

(country): U S A

Name of father: Henry C. Clark

Birthplace (country): U S A

Maiden name of mother: Charlotte Ann Scales

Birthplace (country): U S A

Are you White, Colored, Indian or Mongolian: White

Citizen (Yes or no): Yes

Voter (yes or no): No

Church (denomination): Moravian

Married: no

year:

at:

To (maiden name):

Born:

year:

at:

Children

(name):

Born:

year:

at:

Children

(name):

Born:

year:

at:

Children

(name):

Born:

year:

at:

Fraternal Orders: Masonic, American Legion and V.F.W

College Fraternities:

Previous military service or training: Four years in Navy

Education

(Preparatory): 2 years High School

(College):

Education

(University):

(Degrees):

Occupation before entry into service: Teacher in Public School and farming

employer: State of Virginia

Residence before entry into the service

(street number):

(town): The Hollow

(county): Patrick

Present home address

(street number):

(town): The Hollow

(county): Patrick

(state): Va