Membership Application

VHPA-SoCal Membership Application (download doc file)

 

Southern California Chapter – Vietnam Helicopter Pilots Association 

 Jim Grimm, Treasurer – 4607 Everest Circle – Cypress CA 90630

Name:___________________________ VHPA Number_________________

Address:____________________________  City:______________________

State:___________  Zip:_________     Email:__________________________

Application:    New______  Renewal_________ Change of address_____

Type of Membership: General_______  Associate_____

Annual Membership Dues:

General – $25.00    Associate – $30.00

Date:__________

It is necessary for General membership applicants to complete the Military Information section below.

Military Information

Branch of Service:_____________  Rank:________  Flight School Class

Number(s):____________  Dates of Military Service:________________

RVN Unit(s):____________________________

Location of unit(s)_______________________

Dates of RVN Service:___________________

RVN Duties:____________________________

Your Call Sign(s) (please list in order of preference):_______________

_________________________  __________________

Additional Comments:

 

 

The SoCal Chapter – VHPA is a California non-profit 501(c) 19 Veterans Organization whose goals and objectives follow those of the National VHPA Organization, e.g. fraternal and non-political, as implemented at the local chapter level.

 

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