EVERY YEAR EVERY CHAPTER WISHING TO RENEW AS A CHAPTER OF MODERN DAY VETERANS MUST

membership application   2011-12

NAME FIRSTLAST

SPOUSE'S NAME

BIRTHDAY

ADDRESS

OCCUPATION

CHILDREN NAMEBIRTHDAY

ss number or drivers license number_

TELEPHONE

FAXE MAIL

1 . do you object to taking a solemn obligation?________________________

2. What other clubs or originations’ do you belong to?

3. Would you be willing to hold an office with MDV?_________________________

4. Would you be willing to serve on a committee?_____________________

5. What special skills do you have ______________________________

 if renewal card number