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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 in any duty
location between August 5, 1964 and May 7, 1975. |
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APPLICATION FOR
MEMBERSHIP |
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ATTENTION: New members and new
life members
You must submit a copy of your DD Form - 214
form along with this application and dues payment.
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Name: |
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Address: |
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City: |
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State: |
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Zip: |
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Home Phone: |
Work Phone: |
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E-Mail Address: |
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Date of Birth: |
Sex: |
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Optional: |
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Chapter No. |
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Sponsor: |
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___ I am already a VVA member
and want to become a life member.
My VVA Member number is ______________
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Type of Membership: |
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Life Member-Ages 49 and Under : $250 |
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Individual Member -1 year: $20 |
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Life Member-Ages 50-55: $225 |
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Individual Member- 3 years: $50 |
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Life Member-Ages 56-60: $200 |
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Life Member-Ages 61-65:
$175 |
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Life Member-Ages 66+: $150 |
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Optional Time Payment plan- $50 down,
$25/month | |
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Payment Method: |
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Check |
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Money Order |
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Credit Card
(Visa, Mastercard, American Express,
Discover) |
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Credit Card
Number: |
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Exp.
Date: |
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Signature:
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Return your completed application, payment,
and a copy of your DD Form-214 to:
VVA
Oregon State Council
P.O.
Box 1221
La
Pine, Oregon 97739
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