Vietnam Veterans of America
Send to: Joe Wilson Sec/Tres. 4608 Magazine Ave. Huntington WV 25704
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 -$250 (age 49 and under) $225 (ages 50-55)
$200 (ages 56-60) $175 (ages 61-65) $150 (ages 66 and over)
□ Life Membership – Optional time payment plan - $50 down, $25/month
Payment Option: □ Check □ Money Order □ Credit Card (Visa, MC, Amex)
Credit Card #: _______________________________ Exp. Date: ___________
Signature: __________________________________ Date: ________________
□ I am a spouse/family member or friend of a Vietnam Vet and would like to join Association of Vietnam
Veterans of America.