The Center for Sixteenth Century Studies “The Biggins”

Membership Application – Reenlistment (please copy this form if needed!)

_____Check if Multiple members, place names, etc. on back.           Date:____________

Last Name:______________________First Name:_______________Middle:______________

Fairename(s) or Biggins’ Name(s):________________________________________________

Mailing Address (if it has changed in the last year)
___________________________________________________________________________

___________________________________________________________________________

Communications: (optional)

Telephone:_______________ Cell. Phone/Pager:________________Fax:_________________

Email:_______________________________________________________________________