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ApplicationClick on printable view icon to print application. Please fill out completely. Please email Captain Jefferies for his address to mail him the application. Thank you.
Buckner’s Battery / 6th Kentucky Infantry Company C, Inc.
and
6th Kentucky Infantry Regimental Field Hospital, CSA, Inc.
Civil War Reenacting and Living History Non-profit Companies
Membership Application
Name (please print) __________________________________________________ Spouse/Children (if joining) ____________________________________________ Address _______________________City ____________ State _____Zip ________ Phone _________________________ Cell Phone ___________________________ Email ___________________________Medical Info _________________________ Please check one. _______ 6th Kentucky Infantry, Co. C _______ Buckner’s Battery Artillery _______ 6th Kentucky Hospital _______ Civilian Please note: Buckner’s Battery / 6th Kentucky Infantry, Company C, Inc. and 6th Kentucky Infantry Regimental Field Hospital, CSA, Inc. are not responsible for damage to or loss of personal property or personal injury. I have read and agree to abide by the Unit guidelines. Sign _____________________________________Date____________ |
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