Membership Application

American GI Forum

© American GI Forum, Omaha Chapter, 2008, All Rights Reserved

To apply for membership in the AGI Forum—Omaha Chapter:

 

1.  Please provide the information requested below.

2.  Print the completed page.

3.  Send:

           -  A copy of the completed page

           -  Your check for dues, made out to the American GI Forum.                  Annual membership dues are $30 for men and $20 for women.                 A lifetime membership is $250 for men and $250 for women.

           -  If you are a veteran, include a copy of your DD Form 214                     (Certificate of Release or Discharge From Active Duty) or

              copy of your United States Uniformed Services ID Card to the:

        

                                  American GI Forum—Omaha Chapter

                      Attention:  Membership Application

                         2002 N Street

                    Omaha, NE  68107

Last                                          First                                   Initial       

Name:

 Address:

Street

City                                             State                      Zip Code               

 Veteran:

U.S. Citizen:

Gender:

Date of Birth:

Day            Month           Year

Birthplace:

City                                   State                      Country

I request consideration for membership in the American GI Forum—Omaha Chapter’s (select one)                            

 

as a (select one)                             

Date Submitted:

Day        Month       Year

eMail:

Home Phone:

Work Phone:

Applicant or Renewing Member’s Signature

Omaha Chapter