MARINE CORPS LEAGUE

APPLICATION FOR REGULAR MEMBERSHIP

(Please print all entries clearly)

                                                                                                                                                         

Type of Application - New (__)

Renewal (__) Member #: ____________

 

Date of Application:___/___/___

 

Name: ___________________________________

Address: __________________________________________

Apt #:_____________

 

Address: ___________________________________________________________

City: ____________________________ State: ________________Zip:_________

 

Your Phone: ____________________________________________

Your E-mail: ____________________________________________

Date of Birth: ____ / ____ / ____ Age:___

Date of Enlistment/Commissioning: ___ / ___ / ___

Date of Discharge/Separation/Retirement: ____ / ____/ ____

Service #: ______________________

 

(___) I hereby apply for Membership in Silver City Detachment #45, Marine Corps

League and I am enclosing $27.00 for one year's membership dues.

 

(___) I hereby apply for membership in the Marine Corps League as a Member-at-

Large (MAL), and enclose $27.00 for one year's membership.

 

All memberships include 1-year subscription to MARINE CORPS LEAGUE

MAGAZINE

I hereby certify that I have served as a U.S. Marine for more than 90 days, that the

Character of my service has been honorable, and if discharged, I am in receipt of an

Honorable discharge. By signature on this application, I hereby agree to provide proof of

Honorable discharge/service upon request.

 

 

________________________________

Applicant's Signature

 

 

________________________________

(Sponsor-where applicable)

 

Upon completion of application, turn in to your detachment sponsor with a copy of your

DD214 Form or equivalent and required dues payment of $27.00 made payable to Marine

Corps League.

 

All applications and documents should be mailed to:

Ron Perry

Silver City Detachment #45, Marine Corps League

20 Clinton St

Meriden, CT 06450-4517