485th Tactical Missile Wing
Alumni Association

Associate Life Membership $ 50.00

Associate 3-year Membership $ 10.00

Please complete this Application for Associate Membership and mail to:

485th TMW Alumni Association
P O Box 339
South Montrose PA 18843-0339
________________________________________________________________________

APPLICATION FOR ASSOCIATE MEMBERSHIP
(please print)


LAST NAME:_____________________ FIRST NAME:___________________ MI:____
ADDRESS:______________________________________________________________
CITY:_______________________ STATE:________ ZIP:__________ PLUS:______

Home Phone  (      )                         Work Phone(civ)  (      )

Email___________________________________

RELATIONSHIP TO GLCM OR THE ASSOCIATION _______________________________________

IN ORDER TO MAINTAIN OUR STATUS AS A VETERANS ORGANIZATION PLEASE COMPLETE THE FOLLOWING:
(INCLUSIVE DATES)
DATE ENT. ACTIVE DUTY (MM/DD/YY) ____________________

DATE DISCH/RETIRED (MM/DD/YY) ____________________

[ ] Yes, I want to be an Associate member of the Association
           [ ] No, I am unable to join at this time but keep my name
on the mailing list.
[ ] Enclosed is a donation to the Association........
Amount enclosed:______________

PLEASE MAKE CHECKS PAYABLE TO: 485th TMW Alumni Association