JOHNS CREEK VETERANS ASSOCIATION Membership Application
(Incorporated January 13, 2012)
Applicant's Name
*
First Name
Last Name
Email
*
example@example.com
Phone Number
*
Please enter a valid phone number.
Format: (000) 000-0000.
Address
*
Street Address
Street Address Line 2
City
State / Province
Postal / Zip Code
Date of Birth
*
-
Month
-
Day
Year
Date
Branch of United States Service (Selection also includes National Guard)
*
Army
Marines
Navy
Air Force
Space Force
Coast Guard
Other
Active Duty Dates of Service (Start to Discharge)
Activities of Interest to You:
Veteran Aid Support
Color Guard
11th Hour Squadron
Memorial Walk Team
Senior Outreach
Membership Growth
Event Coordination
Fundraising
Women's Events
Service Officer
Other
Please Upload a Copy of your DD-214 (long form which includes type of separation) or Equivalent to Validate your Service. For your privacy, it is recommended that you black-out your SSN on your form before submitting.
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