CONFEDERATE STATES MILITIA
Membership Application

INSTRUCTIONS: Fill out all applicable information below then copy and paste the completed form to an email and send it to [email protected]. Or you may print this application and mail it to: CSM, P.O. Box 53, Tate, GA 30177.

Name:
Mailing Address:
City:
State:________ Zip:_______
Date of Birth:
Telephone Contact Number:
Email Address:

PRIOR MILITARY SERVICE:

Branch:
Rank:
Job Title:
Enlistment Date:
Separation Date:

EDUCATION:

High School graduate? Yes___ No___
College:
Technical or Trade School:
Professional Skills:

Other Related Skills (ROTC, National Guard, etc.):

Other experiences that will help in the function of this Organazation:



Service Preferences (communications, marksman, infantry, medical, engineering, etc.). Please list any and all that you would be interested in:

Volunteer Statement

I, ______________________________________, understand that I am not enlisting for a set amount of time. Instead, I, as all members of the Confederate States Militia, am a volunteer and, upon sufficient advance notification, am capable of altering my enlistment status at anytime. Furthermore, as a volunteer I acknowledge that I will receive no pay or benefits for my service, but instead have the honor of serving with the most dedicated, honorable, and loyal military force on earth. My honor is my loyalty.

I, ______________________________________, am volunteering my service for a period of _____ year(s).

Enlistment Oath

I, ___________________________________, do solemnly swear (or affirm) that I will support and defend the Constitution of the Confederate States of America against all enemies, foreign and domestic; that I will bear true faith and allegiance to the same; and that I will obey the orders of the officers appointed over me, according to regulations and the Uniform Code of Military Justice. So help me God.

_________________________________
Electronic Signature

Date:

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