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82ND Airborne Division Association Membership Application

(    ) New Member                   (    ) Renewal                     (     )  Reinstatement      

Enclosed is $15.00, my membership dues for the year____________, subscription to the Paraglide included.
New Members must include proof of glider/Airborne qualifications or service with the 82d airborne Division.

Last Name:_________________________    First: __________________  MI: ______________

Address: _____________________________________________________________________

City, State Zip Code + 4: ________________________________________________________

Rank: _____ASN or SSAN: _________________E-MAIL ADDRESS:_____________________

Airborne Unit(s): ________________________________________________________________

Dates of Airborne Service: _______________________to ________________________________

Present Occupation: __________________________Single: __________Married: ______________

Spouse's Name: ____________________# of children: ____ Phone #: (      ) ___________________

Make check payable to:  Treasurer, Fayetteville Chapter, 82nd Abn. Div. Association, Inc.
P.O. Box 40933, Fayetteville, NC 28309-0933

PRINT OUT FORM AND SEND WITH CHECK