Montford Point Marine Association, Inc

HOME OF THE ORIGINAL MONTFORDPOINTERS

Membership is open to all Veterans and Active Duty member of all branches of the Armed Forces, regardless of race, creed, or national origin.

Current Membership fees:

____ I hereby apply for membership in both the National MPMA and the New York Metropolitan Chapter and enclose $60.00 for a one year membership.

____ I hereby apply for membership in the New York Metropolitan Chapter only and enclose $35.00 for a one year membership.

____ I am on Active / Reserve Duty and hereby apply for membership in both the National MPMA and the New York Metropolitan Chapter and enclose $45.00 for a one year membership ($25.00 applied to National & $20.00 applied to NY Chapter Dues).

I Certify that I have been a member of the United States Armed Forces for more than 90 days, and I have received a honorable discharge at the time of my separation from duty.

If you would like to become a member, please print the membership application and mail your application to MPMA New York Metro, 346 Broadway Room 806, New York, NY 10013, or contact your local MPMA representative at 212-267-3318 Fax# 212-442-4170

Last Name:______First Name: ______MI: _____

Address: ______City: ______State: ______Zip Code: ______

Email Address: ______

Home Phone: ( ) _____ - ______Work Phone: ( ) _____ - ______

DOB: MM: _____ DD: ______YYYY: ______Branch of Service: ______

Active [ ] Retire [ ] Veteran [ ] Rank ______Service Id#: ______

Membership Type: Life [ ] Partial Life [ ] Annual [ ] Lifetime membership fees are base by age the current fees are as follow:

Up to age 29 cost is $300.00, 30-39 is $275.00. 40-59 is $200.00, 60 and up $150.00

I certify that I have honorably served in the United States Armed Forces for more than 90 days, and that I received an Honorable discharge at the time of my separation. By signature of this application, I agree to provide proof of my discharge upon request.

Applicant Signature: ______Date: ______

Join the ranks of the Montford Point Marine Association, Inc. Help Preserve the Legacy of these heroes. Participate in viable Veteran Programs, meet and work with the 1st African Americans in U.S. History to earn the title of United States Marine!!!