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The 506th Airborne
Infantry Regiment Association (Airmobile - Air Assault)
2013 Annual Membership
Dues Form
Download Membership Application [pdf]
Regular Membership: Annual $25.00 [ ] OR 5 Years $115.00
[ ] for The Currahee!
newsletter AND
Select [X] one of the following:
[
] Era that you served/Company Roster OR
[
] Roster of all Eras of the Regiment [available
ONLY to those with eMail addresses]
Request for Exemption
from Dues (Veterans only): [ ] Receive The Currahee!
newsletter only
Additional postage
to address outside US:
$ 5.00 [ ]
Optional Donation for Expenses: $___________
TOTAL AMOUNT ENCLOSED: $___________
Select [X] ALL that apply:
Company: HQ/HHC/HHT/HHB[ ] A[ ] B[
] C[ ] D[ ] E[
] F[ ] G[ ]
H[
] I[ ] K[ ] L[
] M[ ] SV[ ] Mortar
Battery[ ] CSC[ ]
BN: REGT[ ] 1st ABN BG[ ] 1st
BN[ ] 2nd BN[ ] 3rd BN[
] BdeCMD[ ]
4th
BSTB [ ] 801st BSB [ ] 1-61st CAV [ ] 4-320th
FA [ ]
ERA: WWII 1942-1945 [ ] Training
1948-1956 [ ] 1st ABN BG 1956-1964
[ ]
ABN
INF 1964-1967 [ ] Vietnam 1967-1971
[ ] AMBL 1972-1974 [ ]
AASLT
1974-1984 [ ] Korea (2ID) 1987-2004
[ ] Iraq (2ID) 2004-2005 [ ]
4BCT
2004-present [ ]
If applicable, your unit which was
assigned to or supported the 506th: _________________
Dates of Service with each 506th
unit (mm/yy):
__________________________________
Rank (Current or at
Date of Separation from Military): ____________________________
Last Name: _____________________
First Name: _________________ M.I. ____
Street Address /PO Box:
_______________________________________________
City: ____________________________
State: _______ Zip Code: _____________
eMail Address: _______________________________________________________
Phone Numbers (Please include area code):
Home: _________________________
2nd Phone: __________________________
Payment Options (choose one below) |
Check Enclosed - Check Number |
AMEX |
Visa |
MasterCard |
Discover |
|
Card Number |
|
CVC Number (Code on back of card) |
Expiration Date |
Card Billing Addres |
Card City, State, Zip |
Name on Card |
Signature |
TOTAL AMOUNT ENCLOSED |
$ |
Select [X] one or more of the following
options if they apply:
Change [ ] Add [ ]: Name [ ]
Mailing Address [ ] Phone number(s) [ ] eMail [ ] Other [ ]
[ ] I request my contact information not be listed in either
the 506th Association Roster or the Currahee
eMailRoom, nor that it be given to anyone other than an Association
Officer without my express consent.
Payment can be made by credit card or make your check or
money order payable to:
The 506th Airborne Infantry Regiment Association
Mail this Membership Dues/Donation Form and your payment to:
The 506th Airborne Infantry Regiment Association (Airmobile - Air Assault)
Attn: Membership, 950 Glenn Drive, Suite 150, Folsom, CA 95630
(855) 506-0506 | 506thmembership@506infantry.org
These pages are maintained the
506th Airborne Infantry Regiment Association (Airmobile - Air
Assault)
This page updated
05/30/2013
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