Membership Application Form

Personal Details

Title:

Full Name

Address :

Post Code

Telephone

Home

Work

E-mail Address

Date of Birth

Age Now

Height
(Males)

Own
Transport?

YES  / NO

Interests, skills, etc

Which aspects/periods of Roman History interest you most?

Have you any skills /hobbies which might be helpful to the  Society?

Other ( please specify)

If drill squad, please  tick
whether you wish to enrol in

Legionary

infantry

Auxiliary
infantry

Auxiliary
archers

Emergency contact

Name

Telephone

Details of any health conditions,
 regular medication, etc.

I agree to the above information being stored in a computer databank.
I agree to abide by the rules of the Roman Military Research Society. I understand that the Society is covered by Public Liability Insurance, but cannot be held responsible for any personal injury sustained by me in the course of any events or activities undertaken as a member of the Society.
I enclose £20 annual subscription (Cheques made payable to Roman Military Research Society)

Signed

Date

Signed

                                                                   **

Date

** Signature of parent or Guardian if under 16 N.B. Please understand that you must accompany your child to events and that your child will not be able to partipate in drill displays if younger than 16 years old.

Please return completed form with your remittance to :

Pete Noons
190 Lightwoods Rd
Smethwick
West Midlands
B67 5AZ