Membership Application

I certify by forwarding this application that I (or a qualifying relative) have/has served at least one day of active military duty during the dates marked below and was honorably discharged or am/are still serving honorably.

First name:

Middle Initial:

Last name:

Suffix:

Your email:

Date of birth:

Street address:

City:

State:

Zip code:

Phone number:

Branch of service:

 
Dates of service: to

Overseas location:

Dates at overseas location: to

Do you wish to join as an annual pay member or a life pay member?

(For more information on life membership, click here.)

Are you interested in volunteering?

 
Recruited by:

Any questions or comments?

If you have a PDF scan or other image of your DD214, please attach it here, with the social security number blacked out. (File size limit for each attachment is 2 mB.)

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