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"For
Office Use Only"
N/R_________________
CH_____________________C/S_______________ RB__________________
Having served with or been attached to, or as a friend of the 4th
Infantry Division, I hereby apply for membership and enclose $20.00 for annual
dues.
Make
checks payable to: 4IDA
Check One:
WWII
Vietnam
Cold
War
Peacetime
Gulf War
Active Duty
Memorial
Associate
I
Request placement in:
Unit
Chapter:
[X] Ivy
Dragoons (3/8th Vietnam)
Name: _______________________________________________________.
Unit: ______________________________________________________________.
Month/Years : ____ /____ to ____ /
____ Nickname:__________________.
Address:_____________________________________________________.
City:
________________________. State: _________. Zip:
____________.
Phone: (_____)______-___________. Fax:
(____)_______-____________.
Email Address:
________________________________________________.
Spouse's name: _______________________________________________.
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Print
Application and mail to:
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DON KELBY
EXEC,
DIRECTOR, NAT’L 4IDA
PO BOX 1914
ST. PETERS, MO
63376-0035
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