Membership Application
Gamewardens Association, Inc. , Vietnam to Present

To qualify for Membership, you can have been in Task Force 116 or in support of Task Force 116, River Patrol Force, in Vietnam, or in or in support of Riverine Operations as a SWCC or Riverine Operator in any operation 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  |  Mid-West Chapter  |  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=$200.00 _______     Life+=$225.00 ______ (includes $25 donation)
Biennial (dues paid every other year) =$50.00 _______     Associate=$15.00/yr._____

AMOUNT ENCLOSED $____________ Cash, Check, Other

Received by _______________________ Date _________ Check Number______________

Mail to:National President, 80 E. Campus Dr - Belfair, WA 98528
If you have any questions concerning Gamewardens Association, Inc., Vietnam to Present. Please call Heinz Hickethier on our toll-free line 1-866-220-7477 or E-mail: president@tf116.org.