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MARINE
CORPS LEAGUE
Metro
South Detachment 1115
PO
Box 4605 Brockton Ma. 02303
Phone (508)583-0348
Type of Application - New
[__] Renewal [__] Member #: ____________
Your
Information:
Name:____________________________________________________________
Address:
__________________________________________________________
City:
___________________________State: _______Zip Code:
______________
Your Phone:
____________________E-mail:______________________________
Date of Birth: ____ / ____
/ ____
Date of
Enlistment/Commissioning: ___ / ___ / ___
Date of
Separation or Retirement: ____ / ____/ ____
Service #:_________________
I am applying for:
(___) New Membership enclose $30.00
(___)Renewed Membership into Metro South
Detachment $30.00
(___) Life Membership
(in effect as
of Jan 1 2007 - must be a member for 1 year in good standing)
age: 0-35 $325
age: 36-50 $400
age: 51-60 $250
age: 61 and over $125
**
Please print all entries clearly. Mail your
application , payment and a copy of your DD-214 or proof of
service to the address above.
** If you want to transfer to Metro
South please call phone number above
** Make checks payable to : Metro South Marine Corps League
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