VVOF Mail-in Membership-at-Large Application

Yes I want to join the Vietnam and All Veterans Of Florida as a member-at-large of the Vietnam and All Veterans Of Florida State Coalition.

All information supplied by you is confidential, and will not be distributed to anyone else.

If you chose to join as a member at large you will be entitled to attend all Coalition meetings (4 per year)
and receive the Valuable information that the Coalition offers. This will be done through email. If you decide
to be a member send you name and email address ONLY to USMC-Vietnam-Grunt@att.net
and let Tony know you are a member of the Association. This will begin as soon as payment is made, and if for any reason
you do not wish to receive the information you can request it to be stopped.
INSTRUCTIONS: Type directly on the form. It is important that ALL fields be filled in. Further instructions are at the end of the form.
INFORMATION
Name First: Middle Initial: Last:

Address: City:

Zip: State: Country:

Email Address:

Branch of Service:

Period of Service:

Phone # Just the Ten (10) digit number not a 1

Home Ph: Work Ph:

Date of Birth :

Annual Member-at-Large ($10)

I certify that my US Military Service was honorable, that I have never
subsequently been discharged under other than honorable conditions.



_________________________________________________________
Signature of Applicant above

__________________
Date Signed

Print and mail this completed application, along with a check for $10.00 to:

Vietnam and All Veterans of Florida State Coalition
2304 Woodland Drive
Edgewater, FL 32141-4320

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