New Member Application

82nd Airborne Division Association, Inc.

New members MUST complete all parts of this application

Telephone (______)____________________ Recruited by _______________________________________
Enclosed is $35.00 for (1 year) 20____, Subscription to the Paraglide included.

OR

Enclosed is $_______ for Life Membership ($250 if under 50 years of age/$175 if over 50 years of age.)


Name: ______________________________________ Street: _____________________________________________

City: ______________________________________ State: ______ Zip code (9-digit) ____________________

Rank: ___________________ ASN: ______________________ or SSN: ____________________________

Date of Birth: (_______/_____/19_____)

Airborne unit (be complete) _____________________________________________________________

Date of Airborne service: From (mm/yy)_____________________ To (mm/yy)_____________________

Present occupation______________________________________________

Single Married

Spouse name: _____________________ Number of children ______

Include proof of airborne/glider qualification (DD214, jump school certificate, orders, etc.) or service with the 82nd, 101st, 11th, 17th, 13th Airborne divisions, 18th Airborne Corps, Ranger, Special Forces, Special Operations, or separate Airborne unit.

Print this page and send your check or money order, made out and mailed to:
82nd Airborne Div. Assn.
1528 Shasta Drive
Colorado Springs, CO 80910

AIRBORNE!

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