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MEMBERSHIP
APPLICATION |
| First Name: ______________ MI ___ | Nickname: __________________ | Last Name: __________________ |
| Address (Street or
PO Box)): ______________________________ |
City: ______________________________ |
State
ZIP (+4
if you know): __________ ____________________ |
|
Phone
(Day): |
Phone
(Night): ( ) ____________________ |
Email: __________________________ |
| Occupation: ____________________ | Spouse's Name: _______________ | |
|
Veteran Status: WWII Korean Vietnam Gulf (1991) Other: ______________________________ |
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| Entered service: _______________ | Discharge date: _______________ | |
| Spouse, widow or widower of: ______________________________ (veteran with above service dates.) | ||
| Training: (School,
etc.) ____________________________________________________________________________________________________ ____________________________________________________________________________________________________ |
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| Combat:
(Group, Squadron, Missions, etc.) ____________________________________________________________________________________________________
____________________________________________________________________________________________________ ____________________________________________________________________________________________________ |
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| Continued
Service: ____________________________________________________________________________________________________
____________________________________________________________________________________________________ |
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| Civilian
Career: ____________________________________________________________________________________________________ ____________________________________________________________________________________________________ |
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| Special
event or memory: ____________________________________________________________________________________________________ ____________________________________________________________________________________________________ |
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| (Use additional paper if mailing in and more space is needed.) | ||
| Signature: _____________________________________________________________________ | ||
| Date: _________________________________________________ | ||
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