- Name
Address
City
State
Zip +4
County
Date of Birth
Sex: Male
Female
Home Phone
E-mail (home)
Work Phone
E-mail (work)
Spouse's Name
-
Membership Type
(You must submit a copy
of your DD Form - 214 form along with this application and dues payment.)
- Membership is open to Vietnam and Vietnam-era
veterans who served on active duty in the
U.S. military (for other than training purposes) between February 28, 1961,
and May 7, 1975
(in-country Vietnam), or between August 5, 1964, and May 7, 1975, for
Vietnam-era veterans.
Type of
Membership:
Individual
Member -1 year: $20
Individual Member- 3 years:
$50
Life
Member-Ages 49 and Under : $250
Life
Member-Ages 50-55: $225
Life
Member-Ages 56-60: $200
Life
Member-Ages 61-65: $175
Life
Member-Ages 66+: $150
Optional
Time Payment plan- $50 down, $25/month
I
wish to join Chapter #
Click here for a listing of Chapters in Pennsylvania
I wish to remain unaffiliated
Payment
Method:
Check
Money
Order
Credit
Card (Visa, Mastercard, American Express, Discover)
Credit
Card Number:
Exp. Date:
MM/DD/Year
Signature:
___________________________________________
Note:
All other veterans, spouses,
family members, and friends can become an associate
member
of AVVA (Associates of Vietnam Veterans of America).
For an application follow the link to:
www.avva.or
- Welcome
Home and
Thank you for your support!
-
Mail completed form along with
your remittance
and a photocopy of your DD 214 to:
Vietnam
Veterans of America, Inc.
260 Brooks Drive
Beaver Falls, PA 15010
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