9^th New York Cavalry Co.B

Application for membership

Please type or print all information.

Primary Member Name______________________________

Address:_________________________________________

_________________________________________

Phone#:_____________ E-mail__________________

D.O.B.:___________ Occupation:_________________

Single ($18.00)____or Family($36.00)____Membership

Additional names of participating family members under 16 as of the February meeting:

Additional names of participating family members 16 and over as of the February meeting:

I have received, read, and understand the by-laws and rules as set forth by the 9^th New York Cavalry Co. B and agree to uphold and abide by the same.

Signature of applicant:______________________________

Make checks out to: 9^th New York Cavalry and send to:

9^th New York Cavalry

C/O Terry Schutz

258 Zimmerman St.

N. Tonawanda,, NY 14120