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

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Merrillville 2005 Event Registration Form

Hidden Lake Park                              Merrillville, Indiana

                                 July 29-30, 2006

                       Reenactor Registration Form

Unit Name:____________________________________________________

Contact Person:________________________________________________

Address:_______________________________________________________

Phone:    (       )                                     Email:                                         

Circle Whatever is Applicable:

USA                                   CSA

Infantry                         Artillery

Civilian                         Medical

Cavalry                         Other:_________________

Number of Participants Attending:____________

Please List the Names of those Attending:__________________________________

______________________________________________________________________

______________________________________________________________________

______________________________________________________________________

Hosted By the 9th Indiana Infantry Company E

Please Print and mail this form to:                 Jack Dusek
                                                                       1628 Holly Lane
                                                                       Munster, IN 46321

OR E-mail this form to: Dusek@netnitco.net 

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Page Last Updated On : April 25, 2005                          

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