FIFTH MAINE REGIMENT MUSEUM
Listed in the National Register of Historic Places

MEMBERSHIP AND VOLUNTEER FORM

NAME:
WINTER ADDRESS:
CITY:                                                        STATE:                        ZIP:
PHONE:                                                   EMAIL:

SUMMER ADDRESS:
CITY:                                                        STATE:                        ZIP:
PHONE:
MONTHS USUALLY AT SUMMER ADDRESS: (please circle)
         Jan.   Feb.   Mar.   Apr.   May    June    July    Aug.  Sept.   Oct.   Nov.   Dec.

Are you a descendent of a Fifth Maine soldier?  Yes ____   No ____

Name of soldier: _____________________________________________
Membership Category:  (please circle)
Individual

$15

Family

$30

 Hundred Club

$100
Patron

$50

 Corporate

$250
I am interested in volunteering for: (please circle)
Board of Directors Arts and Crafts Show
Building Committee Fundraising
Collections Committee Hospitality
Kitchen Committee Museum Docent
Landscaping Committee Pancake Breakfasts
Membership Committee Research
Program Committee Summer Fair
Publicity Committee Suppers

Please return form and dues payments to:

Fifth Maine
P.O. Box 41
Peaks Island, Maine 04108