BGES Membership Application

Print, complete and send to:
BGES Mustering Office
PO Box 129
Danville, VA  24543

            Name_______________________________________________________

            Street Address________________________________________________

            City, State, Zip________________________________________________

            E-mail address________________________________________________

Please enlist me in the:
  Volunteer Regiment at $75 per year

or

Leadership Corps
	Company	$100 - $175
	Regimental	$176 - $350
	Brigade	$351 - $600
	Division	$601 - $1200
	Corps:	$1201 -$3000

    Attached is my check for $ _________________________________________

    Please Charge my VISA / MasterCard#  ______________________________

       Expires:___________________________   in the amount of $______________

      Signature _______________________________________________________