Headquarters
Eleventh
Pennsylvania Volunteer Infantry Company K
Post Office
Box 792
Name:
__________________________________________________________________
Address:
________________________________________________________________
________________________________________________________________________
Phone:
(Home) (_____)________________ (Work)
(_____)________________
E-mail:_________________________
Do
you wish to portray: Military
___________ Military Musician
_________
Civilian
___________ Other (Explain) __________
Male
or female Impressionist:
________________
List
any other family members who wish to participate:
NAME:
____________________________________ Relationship:
____________
NAME:
____________________________________ Relationship:
____________
NAME:
____________________________________ Relationship:
____________
NAME:
____________________________________ Relationship:
____________
Do you currently own any Civil War period uniforms, equipment or civilian apparel,
either authentic or reproduction? YES _______ NO
_________
If
yes, please describe: _____________________________________________________
________________________________________________________________________
________________________________________________________________________
Do you have any medical problems that might prevent you from participating in battle
reenactments, drills, etc.? YES _______ NO
_________
If
yes, please describe: _____________________________________________________
________________________________________________________________________
________________________________________________________________________
Do
you have any prior military service experience? YES _______ NO _________
If
yes, please describe: _____________________________________________________
________________________________________________________________________
________________________________________________________________________
Probationary
membership is to last one year. Dues will be the same as those paid by members.
Probationary
members may attend meetings, and functions, but have no voting rights.
Acceptance as a full member will be determined by a vote of the membership, to
be made at the end of the probationary year.