Name: ________________________________□ Male   □ Female     Date of Birth ______________

Address: _________________________________________Apt:___________________________

City: ___________________________________State: ______ Zip: _______________-_________

Home Phone: (____)______________________Work Phone: (___)_________________________

E-Mail_____________________________________

Huntington Chapter 949   Sponsor: ________________________Sponsor ID No.: ____________

Eligibility:  Vietnam and Vietnam Era Veterans who served on active duty in the U.S. Military
(for other than training purposes) between February 28, 1961 and May 7, 1975 (in-country
Vietnam), or between August 5, 1964, and May 7, 1975, for Vietnam era veterans are eligible.  
Please return this application along with a copy of your DD-214 and $20.00 dues to the address
above.

Term:   __  1 year - $20                __  3 year - $50□

Life Membership - One Time Payment of $100.00. ___

Payment Option:
 __ Check  __  Money Order   __ Credit Card (Visa, MC, Amex)

Credit Card #: ______________________________________ Exp. Date: ____________________

Signature: _________________________________________ Date: ________________________



*Vietnam Veterans of America Chapter #949 meet every fourth Tuesday of each
month except in December.  We are privileged to hold our meeting in the meeting
hall of American Legion Post #16 located at 1421 6th Avenue, Huntington, WV 25701
at 7:00 PM.  Refreshments at 6:30 PM.  
                                                                                 
 Revised  Feb/ 25, 2016
Vietnam Veterans of America
Membership Application
Send application with dues payment to:
Larry Blankenship Sec/Tres
1215 Charleston Ave., Huntington, WV 25701
Make checks payable to: VVA 949
Please do not send cash