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4th Kentucky Volunteer Infantry CS
 
 
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Download the form
pdfClick here to download 4th Kentucky Volunteer Infantry, Inc Enrollment Form

Mail it to :

William R. Neikirk

P.O. Box 814, Somerset, KY 42502

email : bneikirk@windstream.net
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eForm
   
Name*
Address
 
email*
Date Of Birth
Current Employment
Home Phone * + -
Alternate (Cell/Work) + -
Military Service (If Any)  
Hobbies & Special Skills  
Are you willing to travel as part of the Unit to reenactments & other events out of state?
 
Are you willing to follow the orders of the officers & NCOs elected over you, as long as such orders do not violate civil law or moral standards?
Have you ever been a member of any other reenactment or living history organization?
If so, state the organizations, dates, & locations:
Are you familiar with the care & handling of black powder firearms?
Having read the standard operating procedure & authenticity regulation, do you agree to abide by & support them?
 
Was you ever convicted of a felony charge?
 
By Clicking "Button Agree" you hereby agree and promise not to hold the Fourth Kentucky Volunteer Infantry, Inc., or any members thereof liable for any personal injury, property damage, or any other liability whatsoever arising from my participation in any activity of said unit, to include the use of black powder firearms.
I dont Agree
 
 
 

Please complete & click SEND this form, along with a check for $10.00 (made payable to 4TH KY VOL. INF., INC.) to: Bill Neikirk, P.O. Box 814, Somerset, KY 42502. This fee covers recruit dues & newsletter subscription for the calendar year.
Note : If applicant is under age 18, Parent or Legal Guardian Signature is Obligatory.

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Contact us

William R. Neikirk
P.O. Box 814.
Somerset, Kentucky 42502
Cell: (606) 219-0150
E-Mail : bneikirk@windstream.net

 
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