4TH BATTALION
42ND FIELD ARTILLERY ASSOCIATION

Application for Membership

Having served with the 4th Battalion, 42nd Field Artillery, I hereby apply for membership and agree to abide by its
Constitution, Rules and By-Laws. Yearly membership is $20.00 and must be renewed each member year.  
Membership year is Jan 1 - Dec 31.

_______ New _______ Renewal

ERA Served (Check One): ______ WWII _______ Vietnam ______ Cold War (Germany)
______ Peacetime _______ Iraq ______Other (Specify)

I am: _____ Veteran _____Active Duty

I served/am serving with (Battery) ____________ during years _____________

Name: ___________________________________________________________

Address: _________________________________________________________

City: ______________________________ State: ______ Zip: _______________

E-Mail Address: ____________________________________________________

Phone: (______) _______ - ______________

Make check payable to: 4th Bn 42nd Field Artillery Assn.

Mail Application and Check to:

4th Bn 42nd Field Artillery Assn.

Attn: Chuck Carter

122 East Hill Drive

Madison, MS 39110