Application For Membership
Vietnam Veterans of America
Application for Membership
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 any duty location between August 5, 1964 and May 7, 1975.
Attention: New members and new life members. You must submit a copy of your DD Form-214 along with this application and dues payment.
Home Phone: _________________________________Work : _________________________________Cell : ___________________________________
email: _____________________________________________________ Date of Birth: ______________________________
Optional: Chapter No: _____________________ Sponsor: ___________________________
Membership: Life Member - $50.00
I am already a VVA member and would like to become a life member. My current VVA number is: ____________________________
Payment Method: [___] Check or Money order: Make check or money order payable to Vietnam Veterans of America Chapter 1046.
Return your completed applicationwith a copy of your DD Form 214, check, money order:
Vietnam Veterans of America, Chapter #1046
P.O. Box 331322
Atlantic Beach, Fl 32213