Membership Application form:

Print this form page and mail it to:

Marine Corps League Detachment #655
PO Box 883
Eureka, CA 95502

____________________________________________________________________________

 

I hereby certify I have served as a U.S. Marine for more than 90 days, that the character of my service has been honorable, and if discharged, I am in receipt of an honorable discharge. By selecting 'Yes' herein, I hereby agree to provide proof of honorable discharge/service upon request.   Yes         No      

Branch of Service: USMC           USN             

Detachment: 655

Name:                                                                                                                

Address                                                                                                            

City:                                          State/Province:            Zip: Country:               

 

Phone:                                                        Fax:                                             

 

E-mail:                                                                                                              

Your E-mail address is important so that we may contact you concerning your application

 

Date of birth: (mm/dd/yy)       /         /           

 

Date of Enlistment/Commission: (mm/dd/yy)        /        /         

 

End of Service:      /     /                 Service # or SSN#                                            

 

Payment Method: Check/Money Order payable to MCL 655 in the amount of $25/yr.

Signature:                                                                                                          

Please join us at our next lunch meeting on the 2nd Tuesday of each month at the Red Lion Hotel at 1929 4th St. Eureka, CA - 1200 noon

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