USV-JSC Application for Membership

Application for Membership

UNITED STATES VOLUNTEERS-JOINT SERVICES COMMAND
Date submitted: *

Month Day Year
Name: *

First Name Last Name
Address: *

Street Address

Street Address Line 2

City State / Province

Postal / Zip Code
Phone Number: *

Area Code Phone Number
E-mail: *
Legal status: *

U.S. Citizen Legal Resident N/A
Are you 18 or orlder? *

Yes No
Have you ever been convicted of a felony? *

Yes No
Have you served in the U.S. Military? *

Yes No
Enter your highest Rank and Branch of Service. Otherwise, enter N/A. *
Civilian Employment - Name and address of employer: *
Title of your position: *
Enter your highest education degree and name of the school you attended: *
Person to contact in case of emergency: Name, Address, Phone Number: *
I understand that I am applying for a membership with the USV-JSC, and that I will pay my annual dues required by USV-JSC. I certify that the information provided above is true and correct, and that my full name I enter on the right serves as my signature: *
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