AMERICAN LEGION AUXILIARY APPLICATION FOR MEMBERSHIP
 
Please type or print:
Mrs./Miss/Ms (Applicant's Full Name):___________________________________
 
Birthdate: ______________________ Senior (Over 18): ____________________
 
Mailing Address: _____________________________State: _____Zip: ________
 
Work/Home Phone: ________________________________________________
 
Unit Number/Location: ______________________________________________
 
I am eligible for membership through the military service of:
(Full Name): ______________________________________________________
 
He/she is member of:
American Legion Post: ________________________________Post #: _______
City: _________________________________ State: _____________
_________Living
_________Deceased
Living or Deceased, served in:
_______ WWI (4/6/17 - 11/11/18)
_______ WWII (12/7/41 - 12/31/46)
_______ Korea (6/25/50 - 1/31/55)
_______ Vietnam (2/28/61 - 5/7/75)
_______ Grenada/Lebanon (8/24/82 - 7/31/84)
_______ Panama (12/20/89 - 1/31/90)
_______ Persian Gulf War (8/2/90 until cessation of hostilities)
 
Applicant's Relationship to the Veteran:
_______ Mother
_______ Wife
_______ Sister
_______ Daughter
_______ Granddaughter
_______ Great-Granddaughter
_______ Grandmother
_______ Self
(Step-relatives are eligible.)
 
Signature of Applicant: ______________________________ Date: ___________
 
I am interested in learning more about the following:
_______Volunteering at a VA Hospital
_______ Participating in Educational Activities
_______ Helping with Unit Activities
_______ Fund-Raising Projects
_______ Working with Young People
_______ Community Volunteerism/Assistance
 
Check the member benefits on which you would like more information:
_______ Money Market Savings Plan
_______ VIM Paid-Up-For-Life Membership Plan
_______ Displaced Homemakers Fund
_______ Long-Term Care Insurance
_______ Moving Discounts
_______ Scholarships/Continuing Education
_______ Eye Care Plan
_______ Credit Card
_______ Other
 
Recruiter's Name: ________________Unit/Post #: _______City: _______Sate: ___
 
The following individual(s) might also be interested in helping. Please contact:
_____________________________________________
_____________________________________________
_____________________________________________