Vietnam Veterans of America, Inc.
MEMBERSHIP APPLICATION

NAME:__________________________________________________________

ADDRESS:_______________________________________________________

CITY,STATE,ZIP:__________________________________________________

MAILING ADDRESS(if different from above):

_________________________________________________________________

TELEPHONE No.(____)_______________________

PAGER No.(____)___________________

FAX No.( ____)_______________________

E-Mail Address: _____________________@__________________________
______ I am a Vietnam Veteran
______ I am not a Vietnam Veteran (I am applying for Associate membership)
______ Enclosed is payment for 1 year membership :$20.00
______ Enclosed is payment for 3 years membership: $50.00
______ Life Membership
($250 - 49 and below; $225 - 50-55; $200 - 56-60; $175 - 61-65; $150 - 66 & over; $50 & 8 payments)

Payment can be in the form of cash, check, or money order payable to : VVA Chapter 908

If you are transferring from another chapter please include your membership card number #__________________

Print this application form and mail a copy to:

Vietnam Veterans of America
Veterans Helping Veterans
Chapter 908
PO Box 8043
Lynn, Massachusetts 01904-8043

If you are applying for membership as a Vietnam Veteran be sure to include a copy of your DD214 along with this printed form and your payment for one, three years, or life membership.

Welcome to Our Organization
and
Welcome Home !