SECOND MISSOURI INFANTRY
Single _____$18.00 Family_____$22.00 Age 65 or Over_____ $10.00
(Includes MCWRA Membership)
2nd Only Single ____$8 2nd Only Family___$12 Active Military _____$0.00
(Article III of our Constitution states that you must pay Company Dues and MCWRA Dues to be eligible to vote or hold office)
NAME: ____________________________________________________________
ADDRESS: _________________________________________________________
CITY:________________________________STATE:__________ ZIP:___________
PHONE: (Home)_____________________ (Cell) ___________________________
EMAIL:______________________________ Month and Date of Birth ________
(IF FAMILY, List additional family members that live with you and their month/date of birth)
_____________________________ ________________________________
_____________________________ ________________________________
_____________________________ ________________________________
2015 Missouri Civil War Reenactor’s Association
Membership Form
Membership Cost: $10.00 per family per year
_____ Renewal _____ New _____ Information Change
Name __________________________________________________________________________________
Additional Family Names: ___________________________________________________________
Mailing Address: ______________________________________________________________________
City: __________________________________ State: _______________________ Zip: ____________
Phone: ( )_________________________________
Unit Affiliation: 2nd Missouri Infantry, Company K
Email: __________________________________________________________________________________
MCWRA dues are due January 1st with a cutoff deadline of April 1st each year.
