5th Maintenance Battalion (DS) Association

Application for Membership

NAME____________________________________________ DATE______________

ADDRESS:_________________________________________

City State Zip:_________________________________________

TELEPHONE# Include Area Code_______________________

EMAIL:___________________________

 

To post or correct your email on the email list on the 5 th Maintenance Website http://www.5thmaintenancebn.org  NOTIFY Greg Chew   gchew@5thmaintenancebn.org


UNIT (s) WHILE SERVING IN VIETNAM
DATES YOU WERE IN VIETNAM: mm/yy - mm/yy


WHAT IS YOUR PRESENT OCCUPATION?

YES______ I WANT TO JOIN THE ASSOCIATION


YES____I WANT TO RENEW MY MEMBERSHIP WITH THE ASSOCIATION

1 year:  $25.00
2 years:$50.00
3 years:$75.00
4 years:$100.00