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Membership is open to U.S. armed forces veterans
who served on active duty (for other than training purposes) in the Republic
of Vietnam between February 28, 1961 and May 7, 1975, or in any duty
location between August 5, 1964 and May 7, 1975. |
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APPLICATION FOR MEMBERSHIP |
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ATTENTION: New
members and new life members
You must submit a copy of your DD Form - 214 form
along with this application and dues payment. |
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Name: |
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Address: |
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City: |
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State: |
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Zip: |
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Home Phone: |
Work Phone: |
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E-Mail Address: |
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Date of Birth: |
Sex: |
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Optional: |
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Chapter No. |
VVA942 Soddy Daisy, TN |
Sponsor: |
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I am already
a VVA member and want to become a life member.
My VVA Member number is ______________ . |
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Type of Membership: |
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Life Member-Ages 49 and Under :
$250 |
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Individual Member -1 year: $20 |
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Life Member-Ages 50-55: $225 |
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Individual Member- 3 years: $50 |
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Life Member-Ages 56-60: $200 |
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Life
Member-Ages 61-65: $175 |
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Life Member-Ages 66+: $150 |
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Optional Time Payment plan- $50
down, $25/month |
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Payment Method: |
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Check |
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Money Order |
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Credit Card (Visa,
Mastercard, American Express, Discover) |
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Credit Card Number: |
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Exp.
Date: |
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Signature: |
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Return your completed application,
payment, and a copy of your DD Form-214 to: |
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Vietnam Veterans of
America
P.O. Box 64299
Baltimore, MD 21264-4299 |
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