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The Civil War Round Table

Membership Application

You may use the print function of your browser to print the form below (you may fill in the form before printing). You should complete and return the form as soon as possible along with a check for the full amount of the membership category you have chosen made payable to the "Civil War Round Table" or simply "CWRT".

Send your printed and completed form, with remittance to:

Rae Radovich
Registrar, CWRT
PO Box 434
Palos Park, IL 60464

for further membership information, email Rae at raeradovich@earthlink.net



   Enclosed is a check, made payable to The Civil War Round Table, for  .

   Name 

   Address 

   City    State    Zip 

   Home Phone (Area Code) 

   Work Phone (Area Code) 

   FAX Number (Area Code) 

   E-mail Address 

   Regular Member $35.00 per year
   Regular Member with E-Mail Newsletter $30.00 per year

   Sustaining Member $75.00 per year
   Sustaining Member with E-Mail Newsletter $70.00 per year

   Family Membership $40.00 per year   (two immediate family members)
   Family Membership $35.00 per year with E-Mail Newsletter   (two immediate family members)
   Name 
   Name 

   Family Membership $75.00 per year   (three immediate family members)
   Family Membership $70.00 per year with E-Mail Newsletter   (three immediate family members)
   Name 
   Name 

  Name 

   National Member $30.00 per year   (resides over 250 miles from Chicago)
   National Member with E-Mail Newsletter $25.00 per year

   Full-Time Student Member $22.50 per year with E-Mail Newsletter   

   Yes, please send me my monthly newsletter by e-mail so I can be first in the know.   

   How did you hear about the Round Table? 

(The above phone numbers and e-mail address will be printed in the CWRT roster unless you specify here otherwise.)

   Yes, put my information in the roster.   

   No, don't put my information in the roster.