Legio VI Victrix

Member information form

Name:                                                                                                   

Address:                                                                                                

City/State/Zip:                                                                                        

Home Phone: (              )                                                                        

Mobile / Pager: (               )                                                                    

Email:                                                                                                     

Occupation:                                                                                            

Work Phone:(             )                                                                           

Can we call you at work for non-emergencies?                       

Character Name                                                                                      

Character information                                                                               

What other reenactment units / historical societies have you

participated with?                                                                                    

List any Roman-era equipment, clothing or accoutrements you

might possess:                                                                                        

When completed, mail to:

Legio VI Victrix Historical Foundation

Attn:  Membership
2300 W. Victory Boulevard, Ste. A

Burbank, CA 91506