|
|
|
|
|
| FLYING LEATHERNECK HISTORICAL FOUNDATION | |
| All Members Receive: | |
|
|
| Membership
Contribution
$35 Annually |
FOUNDATION MEMBERSHIP FORM NAME: _________________________________________________________
ADDRESS: ________________________________________________________
CITY / STATE / ZIP:__________________________________________________
EMAIL ADDRESS: __________________________________________________
TELEPHONE: ______________________________________________________
SERVICE AFFILIATION & RANK: ______________________________________
PAYMENT METHOD: (mark one)
CHECK: _____
VISA: _____
M/C: _____
DISCOVER: _____
CC NUMBER: ______________________________________________________
EXP DATE: ________________________________________________________
NAME: ___________________________________________________________
(as it appears on credit card) SIGNATURE: ______________________________________________________
(credit card purchase only)
Mail this form with your $35 check to: FLYING LEATHERNECK HISTORICAL FOUNDATION PO Box 45316 San Diego, CA 92145-0316 If paying by credit card you can join by fax: 858.693.0037