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9th Indiana
Volunteer Infantry Company E
.
A Historical Reenactment Association Portraying Union Soldiers from Northwest Indiana

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Ninth Regiment Infantry Indiana Volunteers Company E Application for Membership

The Union Forever!

If you enjoy reading about the civil war period you are in for a exciting experience when you REALLY LIVE the period. To apply, please complete the form below. Many of the questions are necessary for insurance purposes. The "Bloody Ninth" is based out of Northwestern Indiana, there are questions below that are specific to our Illinois members. If you are not from Illinois please disregard.
Your Date of Birth:
Sex:
Marital Status:
Your Significant "Other's" Name, if applicable:
Your Name:

Address:

 

City,State & ZIP code:

Home Phone

 

We are a family unit, what children, age, sex, and names if interested:

 

 


Your E-Mail Address:

Occupation:

 

 

Have you ever been a member of a civil war unit? If yes, name, branch of unit?

 

 

List organizations to which you belong:

 

 

List your hobbies:

 

 

Interest in Civilian, Military or Both:

 

 

If Military, have you ever fired a muzzle-loading firearm?
Are you a member of the National Rifle Association?:
Are you a member of the NMLRA?
If you are a Illinois resident, do you have an ILL. firearms owner's card?
 
Medical History

List serious medical conditions or disabilities:

 

 

List allergies and medications used:

 

 

Do you wear glasses and or contacts?

Name of health insurance carrier:

 

 

Family Physician and phone number:

 

 

In case of emergency notify: list name, address, home and business phone:

 

 

I, the applicant, do hereby state that I have read and understand the constitution, bylaws, and uniform regulations of the Ninth Regiment Infantry Indiana Volunteers Company "E" and will abide by the rules and regulations of this company. I understand that I am to conduct myself in a proper and fitting manner, bearing in mind that the Ninth Regiment Infantry Indiana Volunteers is an official reactivated unit and does wear an historical uniform of the United States Army.
Date:
If under eighteen (18) years of age, parent(s) ir guardian(s) must agree.
I, Mr./Mrs.:
parent/guardian of:
the above mentioned applicant, hereby consent to the applicant becoming a member of the Ninth Regiment Infantry Indiana Volunteers Company "E". I have read the constitution, bylaws, and uniform regulations and I fully understand what is expected from each member.
Date:

Remember to attach the membership file to your email
 

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Page Last Updated On : April 25, 2005                          

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