10th Illinois Volunteer

Cavalry Regiment®
Mounted, Dismounted, Civilian

ENLISTMENT FORM



Name: _______________________________ Birth Date _______________ Age ______

Spouse's Name: ____________________Children's Names/ages: ________________

Address: _________________________________________________________________

City: __________________________________ State ______ Zip Code ______________

Home Phone _________________ Email ______________________________________

Occupation _________________ Work Phone __________________________________

Hobbies, Interests, Talents _________________________________________________

Your Impression: Mounted Cavalry (  ) Dismounted Cavalry (  ) Period Civilian (  )

Previous Reenacting Experience:                                                  Yes (  ) or No ( )

If Yes: What unit, position and rank held? ____________________________________

Do you own period correct clothing, equipment, or firearms? Yes       (  ) or No (  )

 If yes, what type? _________________________________________________________

Riding Experience:                                                                        Yes (  ) or No (  )

  Do you own a horse?                                                                Yes (  ) or No (  )

  If yes:  Do you have transportation for your horse?            Yes______ No______

Stallion______ Mare______ Gelding______

Breed_______________________________ Color________________________

Experienced Cavalry Horse? Yes (  ) or No (  )

I wish to enlist in the 10th Illinois Volunteer Cavalry Regiment® and work to preserve a part of our American heritage through the portrayal of the 10th Illinois Volunteer Cavalry. I, the undersigned, seek enlistment in the 10th Illinois Volunteer Cavalry and hereby agree to the conditions, terms, and bylaws of the charter and by my signature assume the responsibilities and duties of enlistment. I agree to abide by all federal and state laws in the pursuit of this activity. I agree to hold harmless and release any and all claims against the 10th Illinois Volunteer Cavalry Regiment®NFP for any injury or accident which may occur as a result of this activity.

 

Signature (Enlistee) ______________________________________________________

Date ____________

Signature (Commanding Officer) ___________________________________________

Date ____________

Dues for one year enlistment are $20.

Complete and mail to:

10th Illinois Volunteer Cavalry Regiment®NFP

Col. Theodore L. Henry

648 Banta Rd

Low Point, IL 61545




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Form updated February 2010