Name:______________________________________ Date of Birth: ___/___/____
First Middle Last
Address: ___________________________________________________________
Street City/State/Zip
Telephone:(____)___________ e-mail _______________________________
Dates / Branch of Service: ___/___/___ to ___/___/___ Branch:_________________
(See eligibility requirements for membership)
Class of Membership Applied For and Applicable Annual Dues (Circle One)
Dues: Regular: $15 Annual/ $40 Lifetime Associate: $10 POW/MOH/Gold Star: Free
**How Can You Help This Chapter Reach Its Goals?
List Skills and /or Areas You Would Like To Contribute Your Time To
_______________________________________________________________________________________________________________
Eligibility For Membership
Honorable service in the United States armed services, within Korea from Sept. 3, 1945 to June 25, 1950. Within and without Korea from June 25, 1950 to Jan 31, 1955 or as a member of the armed forces of the U. S. as defined by U.S.C. Title 10, served honorably in Korea from Feb. 1, 1955. No person shall be excluded from membership because of race, color, creed, sex, national or ethnic origin, sexual orientation or physical or mental disability, so long as the individual meets the service requirements.
This application when accompanied by the current dues and honored by the Chapter shall be an agreement that the Applicant does agree to abide by and conform to the Chapter Bylaws and Procedures of the Chapter as adopted by the Membership
Applicants Signature: ________________________________ Date: ____/____/____
For Information on membership please contact Ignatius (Chuck) Serra at 772-337-1904 or Jeannie Ricigliano at 772-871-5915.
Membership Meetings: 3rd Tuesday of the month, 10:30 AM at the Disabled American Veterans, 1150 S.W. California Blvd., Port St. Lucie, FL.