Application Form


	Captain John Warner's Company of Green Mountain Rangers wants YOU!

OUR MISSION:

To train in the art of North Country (Frontier) Living during the American Revolutionary era (1775-1783)
To train in the art of soldiering, specifically the ranging service, in the Northern Department of the Continental Army during the American Revolution (1775-1783).
To foster, encourage, and promote an increased awareness, interest, appreciation, and a deeper understanding of the role of Herrick's Regiment of Green Mountain Rangers, specifically Captain John Warner's Company during the Revolutionary War (1777).
To participate in Living History and other history related programs, events, and activities, including Revolutionary War Encampments and Historic Reenactments, that may be conducted from time to time in the general area in which Captain John Warner's Company of Herrick's Rangers served and operated during the Revolutionary War (1777).
To otherwise serve to educate its members and the general public in our Revolutionary War (1775-1783) Cultural Heritage.

If you would like to apply for membership to Captain Warner's Company, please fill in the application form below and submit it for review. Individual membership is $35 and family membership is $50. Please do not send any money until requested to do so.

1. Personal Information

Name:

Prefer to be called:

Address 1:

Address 2:

City: State: Zipcode:

E-mail:

Occupation:

Gender: M F Date of Birth (mm/dd/yy)

Phone numbers - day: evening: Fax:

Please list any special skills that you would be able to contribute to the company

2. Type of application

Individual Family

3. Additional Names

If this is an application for family membership, please enter the names and ages of each family member below:

Name: Age:

Name: Age:

Name: Age:

Name: Age:

Name: Age:

Name: Age:

I have read and agree to abide by the By-laws for John Warner's company of Herrick's Regiment of Green Moutain Rangers. I accept them on behalf of myself and my family. Yes No

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