Form Submission is restrictedForm is successfully submitted. Thank you!Society of the Middle Ages Incipient Group FormApplication for new group.Date Formed*Date Submitted*Proposed Type of Group*CastleTownMarchCantonShireProvinceName of Group:*Date of Group Name Submission*Location of group (city/town)*Proposed Territory claimed by Group:*Physical AddressAddress:*City*AlabamaAlabamaAlaskaArkansasArizonaCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingState*Zip Code*Mailing Address Same as Physical Address?*No YesMailing AddressAddress:*City*AlabamaAlabamaAlaskaArkansasArizonaCaliforniaColoradoConnecticutDelawareFloridaGeorgiaHawaiiIdahoIllinoisIndianaIowaKansasKentuckyLouisianaMaineMarylandMassachusettsMichiganMinnesotaMississippiMissouriMontanaNebraskaNevadaNew HampshireNew JerseyNew MexicoNew YorkNorth CarolinaNorth DakotaOhioOklahomaOregonPennsylvaniaRhode IslandSouth CarolinaSouth DakotaTennesseeTexasUtahVermontVirginiaWashingtonWest VirginiaWisconsinWyomingState*Zip Code*Number of Paid Members*Number of Unpaid Members*Facebook Page URLHas the Social Media Officer Been Added as Administrator?YesNoIf Not, Please State Reason:Group HeraldryDate Groups Device Submitted:Upload Device PhotoDrop files here or click to select% Completed0Events requested, planned, or scheduled:1. Event NameNearest TownDate2. Event NameNearest TownDate3. Event NameNearest TownDateFinancial Assistance from SMA, Inc request?No YesAmount Requested for Event (US Dollars $) Group Officer InformationSeneschalFirst Name*Last Name*Society NameEmail*PhoneMembership Number*Expiration Date*Warranted?*NoYesDate of WarrantExchequerFirst Name*Last Name*Society NameEmail*PhoneMembership Number*Expiration Date*Warranted?*NoYesDate of WarrantHerald or DeanFirst NameLast NameSociety Name*EmailPhoneMembership NumberExpiration DateWarranted?NoYesDate of WarrantMarshallFirst NameLast NameSociety Name*EmailPhoneMembership NumberExpiration DateWarranted?NoYesDate of Warrant Submit