Application for Membership

Fax 435 673 7585 or Mail with Check

NAME____________________________________________ DATE______________

ADDRESS:_________________________________________

City State Zip:_________________________________________

TELEPHONE# Include Area Code_______________________

EMAIL:___________________________

To post or correct your email on the email list on the 5 th Maintenance Web  http://www.5thmaintenancebn.com/. NOTIFY Greg Chew   gchew@5thmaintenancebn.com

UNIT (s) WHILE SERVING IN VIETNAM
DATES YOU WERE IN VIETNAM: mm/yyyy

WHAT IS YOUR PRESENT OCCUPATION?

YES______ I WANT TO JOIN THE ASSOCIATION

YES____I WANT TO RENEW MY MEMBERSHIP WITH THE ASSOCIATION

1 year:  $15.00
2 years:$22.00
3 years:$32.00
4 years:$41.00
5 years:$50.00

Make checks payable to 5th Maintenance Battalion
Send To: Mr. Ken Hamblin
5th Maintenance Battalion
59 North 2120 East Circle
St. George, UT, 84790