Application Request Form

To receive more information about,  and an application to join The Society of  the War of 1812  in the Commonwealth of Massachusetts please use this form.

Thank You.

Please provide the following contact information:

First Name
Last Name
Middle Initial
Street Address
Address (cont.)
City
State/Province
Zip/Postal Code
Country
Work Phone
Home Phone
E-mail
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Copyright © 2000 The  Society of the War of 1812 in the Commonwealth of Massachusetts. All rights reserved.
Revised: January 01, 2000