______NEW MEMBER _____ REINSTATEMENT ______ Enclosed is $15.00, my membership dues for the year _2005_____________, ______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:
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