Application for Membership/Engage the Unit for a Special Program (get as .PDF file)
The LOYAL AMERICAN REGIMENT
(Captain Barns' company)
Anyone who is interested in joining the regiment or engaging us for a special program, please print out this form and fill in the requested information. Then, mail it to the address shown at the bottom of the form. The regiment will review your information and contact you.

I want to learn about joining the regiment
I want to engage the regiment for a special program
What type of program______________________________________________

Please complete the following information :

1. Name: ________________________________________
                         Last                     First              Initial

2. Street Address:_________________________________

3. City:_____________________  State: ___   Zip:_______

4. Telephone: (____) _____-__________ (Home) (Work)

5. E-Mail Address:________________________________

For recruits only:

6. Age:_________

7. Skills and/or any previous reenacting experience:

 

8. Why do you wish to join the LOYAL AMERICAN REGIMENT?

Please Return this form to:

Loyal American Regiment
Attn: Ian Johns
113 Woodpecker Lane
Mount Holly, NJ 08060-1009