4th Brigade  Request for Application Form

Follow the directions below.
For a more secure transmission, contact 4BDE directly by visiting the "Contact IMC" Page.

The following information will go to the Adjutant of the Corps when you click the 'submit' button.
Choose the county that you live in.
Indiana Militia Corps - Online Registration
Enter your name, email address, and other relevant information on the lines below:All items are required. Replace sample text with your info.
Proper name:
e-Mail address, if any:
Age:
Previous military?
List any other skills or talents that you believe you can offer:
Your Phone #:
Mailing address:
Do you have a valid and current Indiana handgun carry permit? (required)
If you don't live in the shaded area, click here to go back to the previous page.
Best time to call you (i.e. "5pm-8pm") :
What is your level of interest in the militia?
Pager #, if any:
Bartholomew
Brown
Clark
Dearborn
Decatur
Fayette
Floyd
Franklin
Harrison
Jackson
Jefferson
Jennings
Johnson
Ohio
Ripley
Rush
Shelby
Scott
Switzerland
Wayne
Washington
Yes
No
Yes
No
Information only!
Mild curiosity
Medium interest
Strongly interested
I WANT TO JOIN NOW!!