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Membership
Form
Having proudly served with the 14th
Infantry Regiment, I hereby apply for membership/renewal and enclose a
copy of my DD Form 214. Donations accepted.
NEW________ RENEWAL_______
Unit: Company: _____________ Battalion:
______ From: dd/mm/yy ______________
To: dd/mm/yy ______________
Name: ______________________________ Nickname:
___________________
Address:
______________________________________________________________
City: _____________________________________ State:
____________ Zip: ______________
Phone: (______) ______-__________ Age: ______ Birthdate: dd/mm/yy
___________
E-Mail Address: ________________________________
Present Occupation: __________________ Single ___
Married ___ Spouse: __________
MAY we provide your contact information to other members of this
Association?
MAY we list your unit, name and dates of service on our website roster?
MAY we list your e-mail address on our website roster?
NOTE: Your address and phone number will NOT be listed on the website
roster.
Mail to: 14th Infantry Regiment Association
c/o Thomas A. Jones
2030 Wynstone Circle N.E.
North Canton, OH 44720 |