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Join High Ground Reenactors!

Thank you for your interest in joining High Ground Reenactors.

Please print and mail the completed application to:

     High Ground Reenactors
     P.O. Box 17621
     Indianapolis, IN 46217

NOTE: Some printers may print black text on a white background better. Please click here if you are at such a printer.

If you prefer, you may request to have an application mailed to you via postal mail by emailing your name and postal address to us at CSAsharpshooters@aol.com

Subsidary applied for? _________________________________________________________
How did you learn about us? ____________________________________________________
Last Name, First Name, MI _____________________________________________________
Postal Address: ______________________________________________________________
Home Phone: ________________________________________________________________
Work Phone:  _______________________________________________________________
Celluar Phone:  _______________________________________________________________
Pager:  _____________________________________________________________________
Web Site Address:  http://_______________________________________________________
E-mail Address: ______________________________________________________________
Date of Birth: ________________________________________________________________
Social Security Number: ________________________________________________________
Employer:  __________________________________________________________________
Occupation: _________________________________________________________________
Education:  __________________________________________________________________
Military Service Branch:  _______________________________________________________
Grade/Rank _________________________________________________________________
Military Occupational Specialty:  __________________________________________________
Hobbies, Interests, Military Training, Skills: __________________________________________
References
Name, Address, Phone Number: _________________________________________________
                                                   _________________________________________________
                                                   _________________________________________________
Name, Address, Phone Number: _________________________________________________
                                                   _________________________________________________
                                                   _________________________________________________
Physician Name, Address, Phone Number: _________________________________________
                                                   _________________________________________________
                                                   _________________________________________________
Medical Insurance & Policy Number: ______________________________________________
Medical/Physical Problems ______________________________________________________
                                                   _________________________________________________
In case of emergency, contact: ___________________________________________________
                                                  __________________________________________________
                                                 __________________________________________________
 

Applicant's Statement

I certify that answers given herein are true and complete to the best of my knowledge. I authorize investigation of all statements contained in this application for membership. By signing and submitting this application form, I agree to abide by the bylaws of the corporation and any other directives deemed appropriate by the corporation. I acknowledge that I may sustain injury while participating as a member. As such, I relieve and hereby agree to hold High Ground Reenactors, Inc., its incorporators, board of directors, officers of the corporation, and members free and harmless from any and all liability issueing out of injury thus sustained by my membership. I understand that false or misleading information given in my application and/or interview(s) may result in denial  of acceptance of membership and/or expulsion, suspension, or termination of membership.

                          APPLICANT
                          SIGNATURE _________________________________ DATE __________

                          PARENT/GUARDIAN
                          SIGNATURE _________________________________ DATE __________
                          (Required if applicant is under 18)



                          Received by: _________________________________ DATE __________

                          Title: ________________________________________

                          Received by: _________________________________ DATE __________

                          Title: ________________________________________

                          Rev 10/97
 

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You are visitor  since November 1, 1997.

UpdatedOctober 3, 1999
http://highground.tripod.com
Webmasters: Michelle Peace and John Peace
(c) Copyright 1996, 1997, 1998, 1999 High Ground Reenactors, Inc.