PERSONAL DATA :

NAME:_____________________________________________________________

ADDRESS:_________________________________________________________

STATE:___________________________________ ZIP CODE:_________________

HOME PHONE:_____________________________DATE OF BIRTH:____________

OCCUPATION:_____________________________

EMPLOYER:_______________________________BUSINESS PHONE:_________

1. Other military living history group(s) you are or have been affiliated with:
 
 
 
 
 

2. Other military living history "impressions" you portray, civilian and military:
 
 
 
 
 

3. Significant military living history events in which you have participated:
 
 
 
 
 

4. Living history work experiences, salaried and volunteer:
 
 
 
 
 

5. Military collecting interests:
 
 
 
 
 

6. Special interests/skills relating to frontier military history (areas of study, on- going research, skills crafts, musical abilities, hobbies, etc.):
 
 
 
 

7. Briefly state why you are interested in joining the General Miles Marching and Chowder Society: