FOURTH U.S. INFANTRY REGIMENT: HOME of HEROES

4th Infantry, 4th Infantry Regiment, Warrior Battalion 1/4, INF 2/4 INF, 3/4 INF,

Membership Form

4th Infantry Regiment Veterans' Association Membership Application
Statement of Service: Having served honorably with the 4th Infantry Regiment, I hereby apply for membership and have enclosed/submitted my dues.  I agree to the membership requirements as stated in the Association Constitution and By-Laws.
(Membership is also open to family members "Tribal Society" and supporters of the association as "Heritage Society" members.)
*
New Membership  Renewal Membership
May we list your name/contact information on our Association Members Roster?
Yes  No  
See Below for Dues Information

Applies to active duty members, retirees, and veterans that have voting privileges.

**  Indicates Non-Voting Members.
*TYPE of MEMBERSHIP PURCHASING.
Regular Membership, Veteran Yearly, ($24.00)*  Tribal Membership, Family Member Yearly, ($14.00)  Heritage Membership, Yearly, ($34.00)  Lifetime Regular Membership ($240.00)  Lifetime Tribal Membership ($140.00)  Lifetime Heritage Membership ($340.00)
Corporate Sponsorship
Bronze  1 year ($150.00) for two designees  3 years ($405.00) for two designees
Silver  1 year ($315.00) for five designees  3 years ($855.00) for five designees
Gold  1 year ($585.00) for ten designees  3 years ($1500.00) for ten designees
PAYING by CHECK or MONEY ORDERS:
If Printing & Sending this Application via USPS, Please send Check or Money Order ONLY, DO NOT SEND CASH!:

TOTAL ENCLOSED:  $__________________
(Make Checks and Money Orders Payable to: 4th Infantry Regiment Veterans Association.)

Mail To:
Richard Wideman
President
4th Infantry Regiment Veterans' Association
P.O. Box 3773
Fort Polk, LA 71459

After Filling out the Membership Form Clicking the Submit Button below (This is only an application not for Online Payment), Then Mail in your payment to the mailing address above. 


PAYING by CREDIT CARD or PAYPAL & PAYPAL BILLMELATER:
When using a credit card go to our Web Store, to make your payment click this link. (http://www.fourthinfantryregiment.org/apps/webstore/) This link will open a new window to make the payment using a credit card.

1) When you are in the Web Store, Click on each Membership you are purchasing by Clicking Add to Cart, and it will add each of your purchase to a your cart. 
2)  Then click Proceed to Check out  (The Checkout Process is a PAYPAL SECURE SYSTEM), and is for PayPal and All Major Credit Cards. 
In the check out process check that your order is correct, then click Check out with Paypal Icon
3)  The payment screen will open Choose a way to Pay, first option is PayPal and Billmelater the second is Don't have a PayPal Account this for all Major Credit Cards.  Fill outthe information then Click Continue
4)  The next screen Click on Credit Card you will enter your credit card information then Click Review and Continue to finish the process.



Questions Please Contact:

Richard Wideman
Phone# 1 (337) 424-2120/1885
Email  4thinrgtwarriors@gmail.com
Facebook  https://www.facebook.com/Fourth.Inf.Regt?ref=hl

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