6thkentuckyinfantry.org: Application
Click 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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