"FORT CIMARRON HISTORICAL PRESERVATION SOCIETY"

I__________________________________Wish to ask the Officers of the Board of Directors of the Fort Cimarron Historical Preservation Society to consider my application for membership in the Fort Cimarron Historical Preservation society. I pledge that I will make every effort to help preserve the history of the Old West, north central Oklahoma and southern Kansas. I further pledge that I will adopt and maintain my historical persona as part of my membership in the society. I will also make every effort to cloth myself in the period correct clothing in keeping with my persona.

NAME:________________________________________

ADDRESS:_____________________________________

PHONE NUMBER:________________________________

E-mail ADDRESS:______________________________

AGE:_________________________________________

PERIOD [date] of YOUR PERSONA:_______________

Dues per year: Adult $50.00 per year. Student $25.00 per year.

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