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Recruitment Form


This information will be used in contacting you about Joining the 19th La Infantry...

Please provide the following contact information:

Name
Street address
Address (cont.)
City
State/Province
Zip/Postal code
Work Phone
FAX
E-mail

Please enter your Birthday:

Date of birth

Why do you want to Reenact the Civil War?



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Last revised: September 23, 1998