SIR

SIR
APPLICATION FOR SIR MEMBERSHIP
First Name
Initial
Partners NameLast Name
Nickname
Address

Home Address Street Apt

Street Address Line 2

City StateState / Province

Zip Code
Address

Mailing Address If Different

Street Address Line 2

City StateState / Province

Zip Code
E Mail Address
Birth Date

MonthDayYear
Date
Area Code - Phone Number
Emergency Contact Name
Relationship
Area Code - Phone Number (other than your cell phone)
Branch 19 Contact Directory: With your permission, SIRs Branch 19, will put your name, address, phone number and partner's name in a directory that is to be distributed to other members to enhance communication. This directory will be updated and distributed annually. | Don't Give Permission I Give Permission
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Signature for No

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How did you hear about SIR?

I am applying []as a New Memberam a[]Transferring Member from Branch
I am applying []as a New Member| am a[]Transferring Member from Branch #

The following information will help us introduce you to new friends and make you aware of our many activities:
FormerCurrent Occupation
With Company or Organization
Applicants Signature

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Date

MonthDayYear
Date
Sponsors Name
Sponsors Badge Number
For Membership Chairman's Use Only:

Approved by Branch Executive Committee A Branch Official will contact you soon regarding the next step in the process.
Approved by Branch Executive Committee
Installed as a Member
Badge
Branch of Service
Year Joined
Year Discharged
Highest Rank
Special Awards
Served During Specific War or Conflicts
Other Information about yourself that you would like us to know:
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SIR

APPLICATION FOR SIR MEMBERSHIP