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Print application and return your completed form, along with payment and a copy of your DD-214 to:
VVA Chapter 266 - 1517 E. Luzerne Street - Philadelphia, PA 19124
For more information, Call: 215-288-7998
Membership is open to U.S. armed forces veterans who served on active duty (for other than training purposes) in the Republic of Vietnam between February 28, 1961 and May 7, 1975, or in any duty location between August 5, 1964 and May 7, 1975.
Application for VVA or AVVA Membership
Name: _______________________________________________________________
Address: _____________________________________________________________
City: ___________________________ State: _________ Zip Code: _______________
Daytime Phone Number:_________________________________________________
Evening Phone Number: _________________________________________________
E-mail Address: _______________________________________________________
Circle your choice(s): VVA AVVA Both
Date of Birth: ____________________________________ Sex: ________________
( ) I am already a VVA Member, my VVA Number is: ______________________
Type of Membership:
( ) Individual Membership - 1 year - $20
( ) Individual Membership - 3 year - $50
( ) Life Membership - Ages 50 - 55 - $225
( ) Life Membership - Ages 56 - 60 - $200
( ) Life Membership - Ages 61 - 65 - $175
( ) Life Membership - Ages 66+ - $150
( ) Life Membership - Optional Payment Plan ($50 down payment, $25 per month)
Return the completed form, payment, and if applicable, a copy of your DD-214 to:
Vietnam Veterans of America
Liberty Bell Chapter 266
1517 E. Luzerne Street
Philadelphia, PA 19124
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