Print this page, fill in the requested information, and mail with a $35 check to:

RHODE ISLAND CIVIL WAR ROUND TABLE
P.O. Box 40712
Providence, Rhode Island 02940

To join the RICWRT, please fill in the application form below and send it to the address above, along with a check for $35 (made out to RICWRT) to cover a one-time-only initiation fee of $10 and $25 annual dues..

MEMBERSHIP APPLICATION

Name _________________________________________________________

Address _______________________________________________________

              _____________________________________________________________

Telephone Number  ______________________________________________

E-mail Address __________________________________________________

Other Civil War organizations you are a member of _______________________

_____________________________________________________________

_____________________________________________________________

Signed  __________________________________  Date ________________