VVA Membership Application

HOW TO JOIN:

Individual membership is open to all Vietnam-era veterans who served on active duty for other than training purposes between Feb. 28, 1961 to May 7, 1975 (in-country); and Aug. 5, 1964 - May 7, 1975 (any duty location). Associate Membership. is open to all veterans, family members, friends, and the general public.

1. Come to our monthly meeting the 2nd Wednesday of the month at 7:30 pm at our building at 9450 East 59th Street at the corner of Lee Road.

Or:

2. Fill out this form, print it, and mail it with a copy of your DD-214 to:
Vietnam Veterans of America, Chap 295
P.O. Box 269279
Indianapolis, IN 46226-9279

Name:

Address1:

Address2:

City:

State:

Zip/postal code:

Country:

Date of Birth:

Sex Male/Female:

Home phone:

Work phone:

e-mail:

Spouse's Name:

Chapter #295:

Sponsor:

Membership Type (select one):

Annual

1 year @ $20. 3 year @ $50.

or Life

age 49 and under @ 250	ages 50 - 55 @225
ages 56 - 60 @ $200	ages 61 - 65 @ $175
ages 66 and over @ $150

Check here for payment plan of $50 down and
the balance payable at $25/month.

Payment
Method

Check Money Order
Visa MasterCard

Card No.

Exp.Date:

Signature

____________________________________ Date:

Please fill in the form online, but print it out and either mail it or take
it to a chapter meeting. Please include a copy of your DD-214.

Email:

Email info:

Phone: (317)547-4748.