Membership Form

All current members are encouraged to renew their membership and recruit new members. Remember, you are this association! Also, please visit our sponsors. We couldn’t support the association without them.
Having served with the 4th Infantry Regiment, I hereby apply for membership or renewal and enclosed are my dues. (Membership is also open to family members and supporters of the association as Tribal Society and Heritage Society members.)

NEW ____ RENEWAL____
Unit: Company ___ Battalion_____ From: dd/mm/yy __________To: dd/mm/yy _____________
Name: _______________________________  Spouse: _____________
Address: ________________________________________________________________
City: ___________________________________________ State:___________ Zip: ____________
Phone: (______)_______-______________ AGE: _______
Email Address: ________________________________________________________________
NOTE: Your address and phone number will NOT be listed on the website roster.
See Below For Dues Information:
Veteran/Active Duty Membership Dues ($24.00 per year)*
Family Member “Tribal Society” Dues ($14.00 per year)**
Heritage Society Dues ($34.00 per year)**
Lifetime Veteran Membership ($240.00)*
Lifetime “Tribal” Membership ($140.00)**
Lifetime “Heritage” Membership ($340.00)
Donation for Memorial Fund ___________
Total Enclosed: ___________
Make checks payable to:

4th Infantry Regiment Veterans’ Association.

Mail to:
Richard Wideman
President
4th Infantry Regiment Veterans’ Association
35 Castlerock Drive
Sanford, North Carolina 27332