AMERICAN LEGION AUXILIARY APPLICATION FOR MEMBERSHIP
Please type or print:Mrs./Miss/Ms _____________________________ ___________ _________ Senior (Over 18) (Applicant's Full Name) (Birthdate) ___________________________________________ _______________________________ (Mailing Address) (Work/Home Phone) ________________ ________ ____________ ____________________________________ (City) (State) (Zip) (Unit Number/Location) I am eligible for membership through the military service of _______________________________ (Full Name) [ ] Living [ ] Deceased He/she is a member of: ________________________ __________ ____________ _____ (American Legion Post) (Post #) (City) (State) Living or Deceased, served in:[ ] WWI (4/6/17-11/11/18)[ ] WWII (12/7/41-12/31/46)[ ] Korea (6/25/50-1/31/55)[ ] Vietnam (2/28/61-5/7/75)[ ] Grenada/Lebanon (8/24/82-7/31/84)[ ] Panama (12/20/89-1/31/90)[ ] Persian Gulf War (8/2/90 until cessation of hostilities) Applicant's Relationship to the Veteran[ ] Mother[ ] Wife[ ] Sister[ ] Daughter[ ] Granddaughter[ ] Great-Granddaughter[ ] Grandmother[ ] Self(Step-relatives are eligible). I certify that the above named individual served at least one day of active duty during the dates marked above and was honorably discharged. __________________________ ___________ __________________________ ___________ (Signature of Applicant) (Date) (Post Officer Membership Verification (Date) or Unit Secretary Verification for Female Veterans Only) ===================================================================== I am interested in learning more about the following: _____ Volunteering at a VA Hospital_____ Participating in Educational Activities_____ Helping with Unit Activities_____ Fund-Raising Projects_____ Working with Young People_____ Community Volunteerism/Assistance Check the member benefits on which you would like more information: _____ Money Market Savings Plan_____ VIM Paid-Up-For-Life Membership Plan_____ Displaced Homemakers Fund_____ Long-Term Care Insurance_____ Moving Discounts_____ Scholarships/Continuing Education_____ Eye Care Plan_____ Credit Plan_____ Other: _____________________ _____________________________ ________________ _______________ _____________ Recruiter's Name (Unit/Post #) (City) (State) The following individual(s) might also be interested in helping. Please contact: ____________________________________________________________________________ ____________________________________________________________________________