Membership Application

YES! I’ll help my fellow veterans by becoming a member of The American Legion. I certify by forwarding this application that I served at least one day of active military duty during the dates marked below and was honorably discharged or am still serving honorably. I have enclosed a check/money order or charge my credit card $30.00 for annual membership dues in Charles Foster Blaker Post 202, Butler Indiana*.

All fields must be completed and application must be typed or printed neatly. Thank You Also please include a copy of your DD214.

Branch of Service (Circle One)
US ARMY
US AIR FORCE
US COAST GUARD
US MARINE CORPS
US MERCHANT MARINE 12/41-8/45
US NAVY

Dates of Service (Circle One)
Aug 2,1990 - Open
Dec 20,1989 - Jan 31,1990
Aug 24,1982 - July 31,1984
Feb 28,1961 - May 7,1975
June 25,1950 - Jan 31,1955
Apr 6,1917 - Nov 11,1918

	Credit Card Type		VISA MASTERCARD DISCOVER
	Credit Card Number		________-________-________-_______
	Exp Date (MM/YYYY)		_______/_______
	Amount		$_________

A portion of the annual dues ($3.00) is allocated to The American Legion Magazine for a 12-month subscription; it is non-refundable and non-deductible from dues.

Please Mail Payment, DD214, & Application to: American Legion Post ___202___

P.O. Box 61 ________________ Contact: ______Membership Chairman _________

___________Butler, IN 46721_______________ Phone: (__260__)_____868-2260___________

First Name

_________________________ Middle Initial ________

Last Name

_________________________________________________

Date of Birth (M/D/Y)

_______/_______/_______

Address

__________________________________________________

City, State, Zipcode

__________________________________________________

Phone Number

(_______)________________________