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 ________________