2007 Brigade Membership Form

MEMBERSHIP FORM FOR Brigade Napoleon 2007
Name: ______________________________________________ Age: _______ Height: __________
Address: _________________________________________________________________________
City: __________________________ State: ______ Zip: _________
Telephone No: ________________ Email: _____________________________________________
 Membership, 21eme Régt., 3e Cie.
 Fusilier
 Medical Team
 Drum Corp
 Camp Follower
 Membership, Guardia Reale Italiana
 Grenadier
 Medical Team
 Drum Corp
 Camp Follower
Membership in the 3e Cie.,
21eme Régt. includes:
Membership in the Guardia Reale
Italiana includes:

Membership, Cavalerie Française

7e Régt. de Hussard

16e Régt. de Dragon

3e Régt. de Cuirassier

15th Kings Hussars
 Other: ______________
Membership in the Cavalerie
Française includes:
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Membership, Brigade Napoleon
Régiment Irlandais
Regimiento Fijo de Puerto Rico
3e Régt. d’Infantrie de Ligne
12th Polish Line Regt.
95th Rifles
Kiev Grenadiers
Other: ______________
Membership in Brigade Napoleon
Includes:
Membership in Brigade Napoleon.
•
Membership in Brigade Napoleon.
•
Membership in Brigade Napoleon.
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Liability and injury insurance at
Brigade Sponsored events.
Liability and injury insurance
•
Liability and injury insurance at
•
Liability and injury insurance at
at Brigade Sponsored events.
Brigade Sponsored events.
Brigade Sponsored events.
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Membership in the 21eme Régt.
•
Cavalerie Française Newsletter.
in Europe.
•
The 3e Cie newsletter.
Please ensure that you have contacted the Unit’s commander before sending in fees.
Additional members at the same address. Copy and fill out form for each active member and attach. Additional members at the same address are $6 each plus $20 for
Family coverage. Only one copy of any notification will be sent to any address unless applied for separately. All participants in events must have proof of insurance.
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•
2007 Dues
Membership period runs from receipt through December 2007 inclusive.
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21eme Régiment, 3e Compagnie
Guardia Reale Italiana
Cavalerie Française
All other units
$30 first year [$25.00]
$30.00
$25.00
$10.00
Signature and date. Signature of Guardian if applicant is under 18 years of age.
Make checks payable to Brigade Napoleon and mail the completed form
to:
James Andrews
Treasurer, Brigade Napoleon
8796 Dunstable Loop
Barstow, VA 20136
Please make sure that you have filled out this form
completely.
Enclose this form and a check of the appropriate
amount made out to BRIGADE NAPOLEON.
Your LHA membership dues and insurance will be
paid out of these funds. Any questions or concerns
about membership should be addressed to your
UNIT COMMANDER.
ANY QUESTIONS OR CONCERNS ABOUT DUES AND MEMBERSHIP SHOULD BE
DIRECTED TO YOUR UNIT COMMANDER.
21e Régiment d'Infanterie de Ligne, 3e Compagnie
Sergent, Mike Mathews, [email protected]
4949 22nd Ave. NW, Rochester, MN 55901-2033
3e Régiment d'Infanterie de Ligne
Sergent-major, Rod Nelson, [email protected]
Glen Burnie, MD 21061
Guardia Reale Italiana
Dave Giovannini, [email protected]
Régiment Irlandais
Peter Twist, [email protected]
RR #1, Orangeville, ON L9W 2Y8, Canada
Kiev Grenadiers
Andrey Mudragel, [email protected]
Regimiento Fijo de Puerto Rico
Col. Jose Torres, [email protected]
3884 Washington Boulevard
University Heights, OH 44118
95th Rifles
Steve Fisher , [email protected]
23rd Foot, Royal Welch Fusiliers
Capt. Jack Pritchard, [email protected]
93rd Sutherland Highlanders
Lt. Col. Jeninngs, [email protected]
www.93highlanders.com
7e Régiment de Hussard, 1er Escadron
Capitaine Nick Serafino
[email protected]
16e Régiment de Dragon
Lawrence Long [email protected]
57 Skyview Drive, Franklin, NJ 07416-2301
3e Régiment de Cuirassier
Maréchal de Logis Nick Serafino
[email protected]
15th Kings Hussars
Ken Hall
[email protected]