Southern California Chapter – Vietnam Helicopter Pilots Association
Jim Grimm, Treasurer – 4607 Everest Circle – Cypress CA 90630
Name:___________________________ VHPA Number_________________
State:___________ Zip:_________ Email:__________________________
Application: New______ Renewal_________ Change of address_____
Type of Membership: General_______ Associate_____
Annual Membership Dues:
General – $25.00 Associate – $30.00
It is necessary for General membership applicants to complete the Military Information section below.
Branch of Service:_____________ Rank:________ Flight School Class
Number(s):____________ Dates of Military Service:________________
Location of unit(s)_______________________
Dates of RVN Service:___________________
Your Call Sign(s) (please list in order of preference):_______________
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.