Third
Recon Association Membership Application
Third
Recon Association
Membership Application
Print out
a copy of this page, fill in all applicable spaces and
mail Application/Donations to the appropriate
address at the bottom of this page.
NAME (Last) _________________________________(First) _______________________(M.) ______
ADDRESS
____________________________________________________
_____________________________________
___________ _________________
City State Zipcode
PHONE (_______) ______________________
Area Code
Number
DATE OF BIRTH ______/_______/___________
Month Day
Year
Email
Address: _____________________________________________
DATE(S) OF SERVICE WITH THIRD RECONNAISSANCE BATTALION (In combat) :
FROM ______________________
/ TO ______________________
(In which year
do you want to be listed?)
RECON COMPANY SERVED IN _____________________ (If more than one, with which one do you wish to be listed?
CORPSMAN INDICATE YES ________
SERVICE NUMBER _____________________________________
AT LEAST TWO REFERENCES OF PEOPLE THAT YOU SERVED WITH IN COUNTRY.
____________________________________________///////////_______________________________________________
Copy
of DD-214 MUST Accompany
Application>>> I
understand submission of this form, and once approved, I will become a member
of the "3rd Recon Association, "I also give permission for my name, address,
phone number,
to be published as part of the Association name and address listing". (For
Bn Assoc. Use Only)
SIGNATURE __________________________________________________________ DATE _____________________
ATTENTION!!!(Mail
Membership Form to:) ATTENTION!!!
Membership
Robert J. Vitiello
4485 94th Ter N
Pinellas Park, FL. 33782-5527
(cell) 727-253-6967
umpav4@yahoo.com
____________________________________________________________________________________________________________
DONATION - $15
Submit Check Payable to: THIRD RECON ASSOCIATION, RVN
ATTENTION!!!
Mail Donations to:
ATTENTION!!!
John J "Doc" Winters
#8 Aspen Court
Pittsburgh , PA 15215
(412)-781-0388
rockhaven1968@aol.com
Treasurer
H