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Associates of Vietnam Veterans of America, Inc ... · PDF fileAssociates of Vietnam Veterans of America, Inc. Application for Membership Mail Applications to: Monument Bank | AVVA

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  • Yearly Membership Dues: (Choose 1 year member or 3 year member)

    1 year: $20.00 3 Year: $50.00 (saves $10) Life Membership Options: (Check all that apply) NOTE: Paying less than $175.00 requires proof of age Paid in Full Payment Plan: (requires $50 down, and $25 per month until paid in full.) Life Member Dues Schedule:

    Age 59 years and under $175

    Age 60 and above $100

    DO NOT SEND CASH

    Payment Method Check Money Order Visa American Express Master Card Discover

    Card #: Expiration Date:

    Cardholder Signature:

    MAKE CHECKS PAYABLE TO AVVA, AND MAIL WITH APPLICATION TO:

    Monument Bank, AVVA Lock Box | 8602 Colesville Road | Silver Spring, MD 20910 Revised: 04/16 F-Mem07.01

    State/Chapter: At-Large? Check here if you Are you a Vietnam Era Veteran?

    New Member: Renewal: Membership #, if known:

    Name: Sex: M F

    Address: Date of Birth:

    City: State: Zip:

    Phone (Home): Phone (Cell):

    Email: (please print clearly)

    Associates of Vietnam Veterans of America, Inc.

    Application for Membership

    Mail Applications to: Monument Bank | AVVA Lock Box 8602 Colesville Rd | Silver Spring, MD 20910

    are a veteran:

    Joanna2

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