VFW POST 4048 - Seal Beach, California

Membership Information / Rouster File Data

First Name:     Middle Name:      Last Name:

Street Address:      Apt#:

City:     State:      Zip Code:      Member Number:

Phone - Area Code:     Number:

Cell - Area Code:     Number:

FAX - Area Code:     Number:

Email Address -1:     Email Address - 2:

Website URL:     Date of Birth (MM/DD/YYYY):

Current Military Status (Select One):  

Branch of Service (Select All That Apply):   NOTE: Use the Ctrl-Key to Select More Than One Branch of Service

War / Conflict Served (Select All That Apply):   NOTE: Use the Ctrl-Key to Select More Than One WAR/Conflict

If Other Selected, List other Confilcts Here:

Period of Service Date 1: From: To:    Type of Duty:

Period of Service Date 2: From: To:    Type of Duty:

Period of Service 3: From: To:    Type of Duty:

Comments:

Is this New or Updated Information?



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