Complete, print and mail the signed form along with your DD-214 to:
First Name: Middle Initial (as req'd)
Last Name: Suffix: Telephone Area Code: Telephone Number:
Mailing Address: Apt.#:
City: State: Zip:
E-mail Address:
My annual dues ($38.00) will be paid by: Personal Check: Money Order: Cashiers Ck.
I served during the following period(s): Check which ones are applicable.
August 2, 1990 - Open Dec.20, 1989 - Jan.31, 1990 Aug.24, 1982 - Jul.31, 1984 Feb. 28, 1961 - May 7, 1975 June 25, 1950 - Jan.31, 1955 Dec.7,1941 - Dec.31,1946 Apr.6,1917 - Nov.11, 1918
Branch Of Service:
US Army US Navy USAF US Marines US Coast Guard
You must complete all appropriate entries
I am enclosing a copy of my DD-214 - (to be returned).
I certify and acknowledge that the above information is true.
Signed: ____________________________, Dated: ______________