Membership

Membership application

Membership Type *

Name *

First

Last

Mailing Address *

Email *

Cell/ Home Phone *

Station *

Rank *

T-shirt Size *

Do you wish to receive Emerald Society social function info? *

Yes No

Are you interested in becoming a member of the Pipes & Drums Band? *

Yes No

If you are interested in becoming a band member, which instrument would you be interested in? *

LIFETIME MEMBERS ONLY: Requested serialized coin number (1st Choice and 2nd Choice) *

Please list any other persons with contact information who may have interest in the Emerald Society: *

Submit Application