49th Fighter Squadron Association   
                         Serving Our Country Since 1941

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 below)
From _______________To ___________________         Relative of 49er    Friend of the 49th

|__| Membership Dues are $25.00 per year, payable every January.  
You can choose to become a Life Member by paying a one time fee, based on your age (See below).

|__| 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 indicate your membership level above and mail your check, payable to the 49th Fighter Squadron Association, to:

John Jannazo
238 East Dixon Ave
Oakwood, OH 45419
email: jannazo@aol.com

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