This is your application for membership in AMVETS Department of New Jersey. Please print this form and mail it with your check to the address below. Please include a copy of your discharge papers.

I am applying for:    New Annual $23.00:__________   (May vary by Post)   Life Member $200.00:_________

Post # :______________  State:_____________ Sponsor :________________________________

Name	:__________________________________________________
Spouse Name	:__________________________________________________
Address	:__________________________________________________
City	:_________________________________ State:____________________ Zip:_____________
Phone	:__________________ Fax:__________________ E-mail:_____________________________

Branch of Service :___________________ Discharge Type :______________________

Date Entered Service :_______________ Date Discharged :_______________ Service # :_____________________

Sex	:_____________ Date of Birth:______________________
Today's Date	:_______________ Signature:__________________________________________

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AMVETS AMERICAN VETERANS ADMINISTRATIVE OFFICE 4202 Route 130, Suite 7-2B P.O. Box 2042 Willingboro NJ 08046 Tel: 609-526-4356 Fax: 609-526-4659 E-mail us at:   amvets@amvets-nj.org

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