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Twenty-first
Michigan Volunteer Infantry
Company H
Membership Application
Date ________________________
Name__________________________________________________________________________
First, Middle Initial, and Last
Date of Birth______________________________________
Please indicate whether individual or family membership____Individual
____Family*
Address________________________________________________________________________
Number Street
City___________________________________________State____________________________
Zip Code_______________
Telephone_____________________________E-mail____________________________
*If a family membership, list names and ages of family members:
Spouse__________________________________________________________________
Name Date of Birth
Child___________________________________________________________________
Child___________________________________________________________________
Child___________________________________________________________________
Child___________________________________________________________________
Are you a first time Civil War reenactor? Yes___________ No ___________
If no, list other unit affiliations: ______________________________________________________
Print and return completed application to:
21st Michigan Vol. Inf.
4481 State Road.
Hillsdale., Michigan 49242
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