VFW Membership Mail-In Application

Print and mail this completed application to:    Cpl Clifton East Smith Sr.
                                                                                       VFW Post 2120
                                                                                3683 Armstrong Rd
                                                                                Springfield Tn 37172-6341

* = Required field

Yes! I want to join the VFW and continue serving my country, my community and my fellow man.

Please enter your personal information:

*First Name _______________________ *Middle Initial _____ *Last Name _______________________

*Street Address ____________________________ *City ________________*State _____*Zip ________

Email _____________________________Phone ___________________

*Service Number or SSN ____________________*Birth date _________________ Date format 'mm/dd/yyyy'

If you're on active duty, please fill in your permanent hometown address:

Same as above _____ (check mark)

Street Address or P.O. Box _________________________ City______________ State______ Zip______

Service information:

Note: Name of Campaign Ribbon or Medal is NOT required if your eligibility is based on receipt of imminent danger/hostile fire pay or service in Korea.

*Branch (choose one)

____ Army____ Marine Corps____ Navy____ Air Force____ Coast Guard

*Eligibility (choose one)

____ WW II____ Occupation Medal____ Korea (7/1/46 to present)____ Vietnam____ CIB/CMB

____ Desert Storm____ Combat Action Ribbon____ Imminent danger/hostile fire pay____ Expeditionary Meda

____ Campaign Medal _____Other

*Describe Other: ___________________________________________________________

*Overseas from: ____________________ to: ____________________ (mm/dd/yyyy)

*Service Location:____________________*Name of Campaign Ribbon or Medal:___________________

*Membership Type: (choose one)

IF you chose Life Membership, please choose one membership fee:

____ Annual $35 ____ Life Membership____ up to age 30 = $425 ____ 31 through 40 years = $410 ____

41 through 50 years = $375____ 51 through 60 years = $335 ____ 61 through 70 years = $290 ____

71 through 80 years = $225____ 81+ years = $170____

Any applicant whose 31st, 41st, 51st, 61st, 71st or 81st birthday will occur after the date of application and on or before December 31st of the current calendar year, shall pay only the fee that would be required on his next birthday.

*Attestation of Eligibility:

Yes! I attest by forwarding this application that I am a citizen of the United States and I have checked the

membership eligibility for the Veterans of Foreign Wars of the United States and find that I am eligible for

membership in the VFW and that I have never been discharged under other than honorable conditions or I

am still serving honorably in the armed forces of the United States of America. I further give authority to

the Veterans of Foreign Wars of the United States to verify my entitlement to membership.

*Signature of Applicant ______________________________*Date Signed _______(mm/dd/yyyy)

*Payment Information:

Check enclosed in the amount of $_____________ (payable to Veterans of Foreign Wars)