Membership Application

82nd Airborne Division Association Inc.

______NEW MEMBER _____ REINSTATEMENT

______ Enclosed is $15.00, my membership dues for the year _2007____________,

______Enclosed is $100.00 Life Membership if over 50 years old ($150.00 for those under 50)

Subscription to The PARAGLIDE and Chapter Newsletters included.

NAME_________________________ ADDRESS____________________________

CITY___________________________ STATE_____________ ZIP _______-_____

EMAIL ADDRESS______________________________________

RANK__________ ASN____________________ or SSN_______________________

AIRBORNE UNITS (ALL) Company/Bn/Regt. etc.

(be complete)_____________________________________________________________

_______________________________________________________________________

Date of Airborne service:

From: (month) ________ (year) ________ To: (month) _______ (year) _______

Present Occupation:_________________________No. Children____________

Spouse's Name__________________Home Telephone(______)__________________

Most of the above information will appear in the chapter newsletter, unless you specify otherwise.

Please indicate what information is not to be made available to other members.

Send proof of airborne qualifiacation (either DD-214 or Jump School Certificate or orders etc)

with your check or money order to:

82nd Airborne Division Assn.

Rocky Mountain Chapter

2122 W. 28th Ave

Denver, CO 80211

303-433-1825 or E-mail: jose973@comcast.net