American
Legion
Auxiliary

APPLICATION FOR MEMBERSHIP
Please type or print

Applicant's
Full Name 
_____________________________
                    
  (First)                         (MI)            (Last)
_____/_____/_____
(Date of Birth)
Senior (over 18)
Junior (birth - 18)
___________________________________
(Mailing Address)
____________________________
(Work/Home Phone Number(s))
___________________________________
(City)                                      (State)      (Zip) 
____________________________
(Unit Number & Location)
__________________________________
(E-mail Address)                    
 
The veteran, Living or Deceased, served in: Applicant's Relationship to the Veteran:
WWI (April 6, 1917 - Nov. 11, 1918)
WWII (Dec. 7, 1941 - Dec. 31, 1946)
Korea (June 25,1950 - Jan. 31, 1955)
Vietnam (Feb. 28, 1961 - May 7, 1975)
Grenada/Lebanon (Aug. 24, 1982 - July 31, 1984)
Panama (Dec. 20, 1989 - Jan. 31, 1990)
Persian Gulf War ( Aug. 2, 1990 until cessation of hostilities)
Mother
Wife
Sister
Daughter
Granddaughter
Great-Granddaughter
Grandmother
Self

I certify that the above named individual served at least one day of active duty during the dates marked above and was honorably discharged.

_________________________________
Signature of applicant

_________________________________
Date

_________________________________
Post Officer Membership Verification
Or Unit Secretary's Verification for Female Veterans Only

_________________________________
Date