49th FIGHTER SQUADRON ASSOCIATION
1941 TO THE PRESENT DAY
PROTECTING AMERICA FOR OVER 60 YEARS
MEMBERSHIP APPLICATION
Date: ____/_____/_____
Name: _____________________________________Date of Birth: ____/____/_____
Spouse's Name: _______________________
Address: ____________________________________________
City: _________________________________________
State: ______ ZIP: ________-_______
Home Phone: (_____)_________________________
Work or Cell Phone: (_____)________________________
E-Mail: _____________________________________________
Years Served in the 49th: or (circle choice)
From _______________To ___________________ Relative of 49er Friend of the 49th
|__| Membership Dues are $25.00 per year, payable every January. If you choose to become a Lifetime member, you may pay a onetime fee, the amount depending upon your age.|__| Up to age 60-----------------$250.00
|__| Age 61-65-------------------- $200.00
|__| Age 66-70-------------------- $150.00
|__| Age 71-75-------------------- $100.00
|__| Age 76 and up-------------- $ 75.00.
Please mail your check, payable to the 49th Fighter Squadron Association, to:
Henry Salustro
1400 L'Ambiance Circle, Apt. 101
Naples, FL 34108-6740
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