2010 American Civil War Association Membership
Application |
| Name: ___________________________________________________________
Home Address:__________________________________________________________ Work City:___________________________ State:____ Zip:_________ Cell Phone ____________________________Phone__________________ Birth Date:______/______/_________ Email:________________________________ |
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Please Circle one Unit: |
Confederate Brigade: |
UnionBrigade: Sykes Regulars 20th Maine Infantry 79th New YorkInfantry 2nd US Artillery 114th Pennsylvania Infantry 2nd Maryland Infantry 24th Michigan Infantry 5th US New York Artillery 69th New York Infantry 2nd Wisconsin Infantry |
ACWA administrative
Use Card # 10-_________________ Amount $__________________ Membership type: New______________________ Renewal___________________ Guest______________________ Supporting Member__________ Payment type: Cash $____Check #__________ |
| 2010 Membership
Fees Visitor Combatant $15 Single $40 Visitor Non-Combatant $5 Couple $45 Supporting, Courier Only $20 Family $50 Sutler $50 Guild $50 Note: Visitor and Supporting fees are applied toward dues. |
Visitor – Event Location
and Date: ________________________________________ Mail appilcations to: American Civil War Assoc. P.O. Box 1652 Tracy, CA. 95378 |
| Member information (please print
clearly) Are you trained in CPR? Yes/No Do you want to be on the ACWA email list for important updates? Yes/No initials _______ Emergency Contact Name: Phone:__________________________ The ACWA has a group of members who are available Monday through Friday 7am-3pm to speak at schools and other groups interested inthe American Civil war. Do you want to participate in this program? Yes/No |
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| Medical information:
Please list all allergies, handicaps, MEDIC ALERT status or other medical information which might impact your ability to participate as a member of the ACWA._________________________________________________ |
| I acknowledge that I am fully
aware of the nature and purpose of the activities of the American Civil
War Association (ACWA). I understand that these activities are potentially
dangerous and I voluntarily accept any risks involved. I understand that
I may be given a copyof the ACWA by-laws and I agree to be bound by the
rules and policies contained therein, whether or not I have been given
or read them. I agree to obey the directions of the governing ACWA official
and their agents at events. Have you ever been convicted of a felony? Yes/No Signature of Applicant: ______________________________________ Date:______________ Signature of Parent or Legal____________________________ Guardian_________________________________Date:________________ |