22D Marines Application

22D Marines Application
New & Renewal Membership's

Please Print, Fill Out & Mail This Form

First Name:

M.I.:

Last Name:

Address:

City:

State:

Zip:

Spouse Name:

Phone:

Co.

Bn. Reg.

Check the Application Box(s)Below

Regular or Associate Renewal

Life Member

$50

Associate Life Member

$50

New Regular Member

New Associate Member

Change of Address or Correction

CHECK BELOW
WHERE DID YOU
SERVE WITH THE
22^ND MARINES

___ Samoan Islands

___ Marshall Islands

___ Eniwetok

___ Guam

___ Okinawa

___China

Date:

Signature:

Enclosed:

Mail To:

Harold Walters

Treasurer

22D Marines Association

143 N Jefferson Rd

Wooster, OH 44691-3209

I Was Recruited By: