COPY, PASTE TO YOUR TEXT EDITOR, AND PRINT
HUNTINGTON MILITIA
INTERNET MEMBERSHIP FORM
Please print this page, complete the form and mail it with
membership dues to
HM Membership
P.O. BOX 422
EAST MEADOW, NEW YORK 11554
FAMILY NAME: ______________________________________________________________________________
ADDRESS: ____________________________________________________________________________________
_____________________________________________________________________________________
EMAIL ADDRESS: _____________________________________________________________________________
TELEPHONE #: ( )______________________________________________________
CELL PHONE # ( )_______________________________________________________
In case of Emergency while at an event - who should we contact (someone not at events with you):
Name: ______________________________________________________________
Phone: ______________________________________________________________
DUES
All members16 and over - $10
Members under 16 with Parent - $2.00
UNDER 18 REQUIRES THAT A PARENT OR GUARDIAN JOIN THIS UNIT AND ACCOMPANY MINOR AT ALL EVENTS
YOUR NAME: _________________________________ DUES: ____________
Family Member: ________________________________ DUES:_____________
Family Member: ________________________________ DUES:_____________
Family Member: ________________________________ DUES:_____________
Family Member: ________________________________ DUES:_____________
TOTAL DUES ENCLOSED: $_________________
Please make checks payable to Huntington Militia