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Membership

24th Michigan Volunteer Infantry Membership Form

Name___________________________________________________________________

Address_________________________________________________________________

City_____________________________________ State_____________ Zip__________

Phone___________________ Fax__________________ E-Mail____________________

Date of Birth_______________________ Born in______________________________

in the State of________________________

Social Security Number (Optional):___________________________________________

Emergency Contact Name:__________________________________________________

Phone___________________________________________________________________

Company Mustered into:___________________________________(Optional)

PLease fill the following information so we can fill out your copy of the enlistment papers

Membership________ Full _________ Family _________ Associate

Eye color________ Hair _________ Complexion _________ Height____ft._____in.

Occupation___________________________________________________________

Recruited by: _______________________________________________ Date: ____________


I, the undersigned, state that I am an United States Citizen and that I have never been convicted of a felony.
I, also, understand that should I ever be convicted of a felony, my membership in the 24th Michigan Volunteer Infantry will be immediately terminated. I understand that if I am between the ages of twelve to eighteen, I must provide a copy of my Hunters Education Certificate along with a written permission slip to join from my parent or guardian. In addition, I understand that The 24th Michigan Volunteer Infantry is in no way responsible for any injury, dismemberment, disability, or death incurred during activities that I attend as a member of the 24th Michigan Volunteer Infantry. I, also, agree that The 24th Michigan Volunteer Infantry is in no way responsible for any personal property lost, stolen, or damaged during activities that I attend as a member of the 24th Michigan Volunteer Infantry

Signature ______________________________________________________

24th MVI Enlist1

Membership Dues:
At this time the 24th Michigan Volunteer Infantry is collecting only the dues required to part of the ACWA (American Civil War Assoc.). It will reserve the right to collect any other dues in the future as decided by voting members

Please Print Form and Mail to:

David M. Mascitelli
1414 Pajaro Ave. #10
Manteca, California 95336

Phone: 925-825-5141

Information subject to change at Yearly Regimental Meeting

1999