Print out version. Fill out and mail to address listed below. |
CFLHS Membership Application |
(Please type or print) Name_________________________________________________________ Date of Birth______________________ Address______________________________________________________ ____________________________________________ zip______________ Phone # (H)_________________________ (W)______________________ e-mail_______________________ SoSec#__________________________ Occupation____________________________________________________ Employer name & address_______________________________________________________ _____________________________________________________________ Please give job description, how long employed, etc. _____________________________________________________________ _____________________________________________________________ Spouse's Name____________________________ & D. of Birth_________ Spouse's SoSec#__________________________ Employer_____________________________________________________ Children... Name Date of Birth Social Security # _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ Please explain how you found out about our unit. _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ Please explain any experience in reenacting, living history, etc. Give name and address of commander of any previous units. _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ Do you play any musical Instruments/sing?_________________________ _____________________________________________________________ Can anyone in your family sew, do woodwork, etc?__________________ _____________________________________________________________ _____________________________________________________________ Please explain why you desire to become a member of Cape Fear Living History Society. _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ Name of sponsoring CFLHS member______________________________ Please explain how you know your sponsor.________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ Please use space below and on the back to include any additional information on other hobbies and interests, ancestors in the War Between the States, or any other information that you would deem to be pertinent. _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ _____________________________________________________________ Make checks payable to CFLHS CURTIS COLE, 547 Wagonford Road Beulaville, N.C. 28518 MEMBERSHIP ____ Single: $25... One person. One vote in Society elections. Society will pay liability insurance. ____ Family: $30+... Husband, wife, and children. Children over 18 must be inschool. Special cases will be reviewed by the Board of Directors. Every member 16 years of age or older must have liability insurance. Society will pay insurance for two (2) family members. Applicant's Signature____________________________Date___________ If under 18 years of age, applicant must have written permission of parent legal guardian in applying for membership. Parent/Guardian Signature______________________________________Date___________ *************************************************************************************** For Unit Use Only To Board of Directors, please review , sign, and pass on. Date Accepted __________________ Unit Number(s) _________________ |
