Sixth New Hampshire

Regiment Volunteers Company E

Historical Association

Membership Form

Name ____________________________________________________________

Address __________________________________________________________

Home Phone _________________ Work phone_______________Email ______________________

Date of Birth ________________ Occupation _________________

Any Civil War American history or New Hampshire history background:

______________________________________________________________________________________________________________________

______________________________________________________________________________________________________________________

Public Contact Experience: _______________________________________________________________________________________________

Hobbies, Organization Affiliations, other related Interests: ____________________________________________________________________

How did you learn of our organization: _____________________________________________________________________________________

Are there family members interested in participating in our association (if so who) _________________________________________________

__________________________________________________________________________________________________________

Which group in our organization are you interested in joining:

Infantry ______________

Musicians _______________

Civilians ________________

Other _________ (ancestor)

Do you have?

Reenacting Experience ___________________

Firearms Experience _____________________

Black Powder Experience _________________

Other Experience________________________

Allergies, or medical problems ________________________________________________________________