*Type of Request:  --Choose One-- New Request Renewal Request Information Update Request  

*Marshal I wish to be:  --Choose One-- Heavy Weapons Marshal Siege Combat Marshal Rapier Marshal Cut and Thrust Marshal Youth Rapier Marshal Youth Heavy Combat Marshal Thrown Weapons Marshal Archery Marshal Equestrian Marshal  

*Type of Marshal I wish to be:  --Choose One-- Local Group Marshal Marshal At Large Regional or Kingdom Level Marshal  

SCA Name:            

 *Modern Name: 

Do we have permission to post your Modern Name on the on-line Marshal Roster:  Yes No           

*Address, City, State, & Zip Code:

*Phone Number:    

eMail Address:    

Do we have permission to post your eMail address on the on-line Marshal Roster:  Yes No           

Would you like to be added to the Æthelmearc Marshal's Yahoo Group?:  Yes No    (eMail address required)

*Membership Number:    

*Expiration Date:    

*My Local Group is: