Membership Application
Gamewardens of Vietnam Assoc. Inc.

To qualify for Membership, you can have been in Task Force 116 or in support of Task Force 116 in Vietnam, or in or in support of Riverine Operations in any event subsequent to Vietnam. If you have left the military service a copy of your DD214 or sponsorship by an active member of Gamewardens of Vietnam Association is required

Please circle the Chapter that you wish to be affiliated with:

West Coast  |  North East  |  South East  |  Mid-Atlantic  |  North West  |  Member at large (National)

PERSONAL INFORMATION: (This information will never be released to anyone!)

Last Name______________________________First Name_____________________ MI______

Address ____________________City_______________ State _________ZIP_______ - _____

Home phone number____________________ Email address______________________________

Work phone number____________________

Spouse's Name________________________ Sponsor's Name______________

MILITARY SERVICE:
Unit Assigned (1)_____ Unit (2)_____Unit (3)______ NIOTC Training Class_____When? Mo./Yr._____

Pay Grade / Rate in country_______________

If still active, present command___________________ Retired____________From to (Mo./YR.)_______

Decorations received:
Navy Cross____PurpHrt____Silver Star____Bronze Star____Combat Action____ PUC____
NUC___MUC___NatDef___ VietCampagn_____ CivicAct____
Cross of Galantry___ Other_________________

Searching for a former "River Rat"? If so, who?_______________________________________________

Type of membership
New_____ Renewal _____Life+=$225.00 ______
Life=$200.00 _______ Biennial (dues paid every other year) =$50.00 _______ Associate=$15.00_____

AMOUNT ENCLOSED $____________ Cash, Check, Other

Received by _______________________ Date _________ Check Number___________________

Mail to:National President, PO Box 701786, San Antonio, TX 78270
If you have any questions concerning Gamewardens of Vietnam Assoc. Inc., Please call John Woody on our toll-free line 1-866-220-7477
or E-mail: jwoody@texas.net.