Membership Application

1

Applicant Name* This field is required.

First Name

Middle Initial

Last Name

2

Address* This field is required.

Street Address

Street Address Line 2

City

State

Zip Code

Country

3

Home Phone

Area Code

Phone Number

4

Cell Phone

Area Code

Phone Number

5

Email

example@example.com

6

Date of Birth* This field is required.

Date

7

Age Group

Birth - 17

18 and over

8

Unit #

9

Location

10

Signature* This field is required.Signature of Applicant

Clear

11

Date

12

Eligible through-Name of VeteranIf living, must be a Legion member.

First Name

Middle Initial

Last Name

13

Veteran is

Living

Deceased

14

American Legion Member ID Number

15

Veteran's American Legion Post Name

16

Post #

17

City

18

State

19

Veteran Served:* This field is required.Check all that apply

WWI (4/16/17 - 11/11/18)

WWII (12/7/41 - 12/31/46)

Merchant Marines (12/7/41 - 12/31/46)

Korea (6/25/50 - 1/31/55)

Vietnam (2/28/61 - 5/7/75)

Lebanon/Granada (8/24/82 - 7/31/84)

Panama (12/20/89- 1/31/90)

Gulf War/War on Terrorism (8/2/90 until cessation of hostilities)

Legion Act (Enter date between 12/7/1941 to the present)

20

Dates of Service

21

Applicant's Relationship to the Veteran:* This field is required.

Mother

Spouse

Sister

Self

Direct Descendant (daughter, granddaughter, great granddaughter, etc.)

22

Have you been a member previously?* This field is required.

YESNO

24

Please verify that you are human* This field is required.