MARINES’ MEMORIAL ASSOCIATION MEMBERSHIP APPLICATION Fax to: 415.563.5820 Mail to: 609 Sutter St., San Francisco, CA 94102 Welcome Aboard!


60th anniversary our living memorial membership benefits


Membership Categories (All donations are tax-deductible and non-refundable): □ Regular Veteran & Retired, all services, including Merchant Marine (wartime): Annual donation $100.00 ($10.00 initiation fee) □ Benefactor Veteran & Retired, all services, including Merchant Marine (wartime): Onetime donation $2500.00 (Guest Cards included)


□ Currently Serving Members of the Armed Forces All Services who visit the Marines’ Memorial Club: Complimentary Membership. Joining via Web or mail requires a $35.00 annual donation.


Membership Information First Name, MI, Last Name: ________________________________________________ Branch of Service: □USMC □USN □USA □USAF □USCG □Merchant Marine (wartime) Military Status: _____________________ Highest/Current Rank: _____________________ Birth Date: ____ / ____ /19_____


Address: ________________________________________________________________ City: ___________________________________ State: _________ Zip: ____________ Home Phone: _________________________ Fax: _____________________________ I certify that I served on Active Duty in the US Armed Forces from __________ to __________


How did you hear about us? □Advertisement or news article (Name of publication: _____________________________)


□Visit to the Club or Theater □Member/family/friend □Site presentation □Other ______________________


Family Members Your spouse, children over 21 years (who are ineligible for membership by themselves) and non-military parents are eligible for Guest Cards. Spouse card is complimentary; all others are $20 annually, per Guest Card. Please list names, relations and ages of those for whom you would like to add. In-laws are ineligible.


Last Name First Name MI Relationship


Processing Your Membership Application In addition to the completion of this application, please attach the following:


• Photocopy of Official Verification of Honorable Service: DD214* or Retired I.D. Card *Note: If you cannot locate your DD214, you can obtain a copy by filling out a Form SF180, which is available for printout on the Marines’ Memorial Website at www.MarineClub.com.


• Appropriate Donation (All donations are tax-deductible and non-refundable)


Circle Payment Type: MC VISA AMEX Diners Club Personal check or other: ________________ Total Amount Due (membership donation + guest card(s)) $ ____________ Credit Card # ____________________________________ Exp. Date ____________ Signature of Applicant ___________________________________ Date ________________ Referred by ___________________________________________


Membership Department Contacts: phone 415.673.6672 x223 fax 415.563.5820 email Member@MarineClub.com Crossroads Spring 2011 25 Age Amount


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looking back


Email: ______________________ @ _________________________


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