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: ____________
Signature ______________________________________________________
24th MVI Enlist1
Membership Dues: Please Print Form and Mail to: David M. Mascitelli Phone: 925-825-5141 Information subject to change at Yearly Regimental Meeting 1999
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
1414 Pajaro Ave. #10
Manteca, California 95336