Application
Form
CA-7
Application for Membership
You must be a member of the National Association
before joining a local chapter or do both at the same time. For National Association
go to www.womenmarines.org
Please
print
Name:_______________________________________________________
Last --first --middle
Your service name:________________________
Rank: ______________
(active duty only)
Address:________________________________________________________________
Street-- city-- state-- 9 digit zip
Date of birth: _____/_____/______
month-- day-- year
Social Security Number:_____________________
Telephone phone #:____________________
Cell
phone#__________________
Service dates: __________to__________
Email:______________________________
Next
of kin:_______________________________ Relationship:____________________ Address:________________________________________________________________
Dues:
Annual anniversary $ 10.00 circle number of years
1 2 3
Life $100.00 must be life member of WMA#__________
Enclosed
dues: $_________
Make check payable to: EMVSC, CA-7, WMA
Signature:___________________________ Date:______________
Mail to:
Marie Proulx, Treasurer, 748
Pearwood Street Oceanside, CA 92056-8618
(760) 433-1526
