MEMBERSHIP APPLICATION

Membership dues in VVA and AVVA are $20.00 per year. VVA applicants must provide a copy of their DD-214 or Form SF-180. You may turn in your application at any meeting or mail to:

VVA Chapter #454, P.O. Box 91297, Louisville, KY. 40291.

I am applying for membership in VVA___________ AVVA____________

Name_______________________________________________________________

Address_________________________________________________________________________

Daytime phone #___________________________

Evening phone #________________________________

VVA applicants only, please indicate:

Vietnam Veteran_______________ Vietnam Era Veteran_________________

Branch of Service_________________________________ Serial or SS #_______________________

Unit served in RVN___________________________________________

from_______________ to________________

Print out this form and mail to the above address.