Payment Type31 Single payment cashcheckcredit card - PDF document

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4 4 4 4 4 Receipt Date Name Payment Type Single payment (cash/check/credit card): Full payment ($300) Down payment ($40) Monthly Recurring Payments (credit card only)Select Monthly Payment Amount: $10 $20 $30 $50 $100Amount Paid $ Payment Method  C  Check oney Order edit CardRec’d by signature ACCREDITED After a minimum down payment of $40 toward your life membership, you will receive your membership card. The remaining balance is paid in interest-free installments. All dues payments received are applied to your life membership account. Apply online for as little as $10 with a recurring monthly credit card payment at dav.org/membership/join-dav.Thank you for becoming a member! Membership Application (Membership eligibility information is on the back of this application.) Date Last Name First Name M.I. ’s Name Address City/Town ZIP Gender:  Male  Female’s Phone No. ( ) Email Date of Birth / / Date Enlisted / / Branch Date Discharged / / Month Day Year Month Day Year Month Day YearRank ervice-Connected Disability % eceiving: A Comp.  VA Pension ervice Retirement  Visually Impaired aring Impaired  POW art  Gassed gent Orange  PTSD  Gulf W  TBI tment Preference eference ’s ID No. Sponsor’s Name ’s Phone No. ( ) ’s ZIP Applicant’s Signature aid $  Single payment: Full payment ($300) Down payment ($40) onthly Recurring Payments (credit card only):Payment Type:  Check # ash  MO  Visa  MC over x elect Monthly Payment Amount: $10 $20 $30 $50 $100Name on Card Credit Card No. - - - E Billing Address Mail application and payment to: National Headquarters, P.O. Box 145550, Cincinnati, OH 45250-5550 | oll Free 888-236-8313 DAV life membership = $300 | eterans age 80 or older = FREELife membership payments are non-refundable andare not tax deductible. DAV Membership EligibilityMembership is open to any veteran wounded, gassed, injured or disabled in the line of duty during time of war and to persons who have been awarded expeditionary or campaign medals. “During time of war” shall include the following periods of service:World War II and Korea ..

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........................................................................................................ ////Vietnam and other engagements ................................................................................................. anian Crisis, Lebanon Crisis, Invasion of Grenada, Invasion of Panama and other engagements ........................................... aq, Afghanistan ...................................................................................................... //until terminated by esidential Proclamation or Congressional resolutionThe requirement “during time of war” may also be met if it is determined that the applicant’s wound, injury or disability was incurred:) at any time as a direct result of armed conflict. xtra-hazardous service under conditions simulating war. tates was engaged in any war.901318 (12/19) Armed Forces Expeditionary Medal (AFEM).Campaign or ExpeditionCongoEl SalvadorLaosLebanonMayaguez Operation Operation in the Libyan Area (Operation Eldorado Canyon)Panama (Operation Just Cause)/// Persian Gulf Operation (Operation Earnest Will)Quemoy and Matsu Island////Taiwan StraitsVietnam (Including Thailand)//// Navy Expeditionary Medal and Marine Corps Medal fortheseoperations.Campaign or ExpeditionCubaIndian Ocean/IranIranian/Yemen/Indian Ocean////LebanonLiberia (Operation Sharp Edge)////Libyan AreaPanamaChinese Service Medal (Extended)////Navy Occupation of Austria////Navy Occupation of Trieste////Units of the Sixth Fleet (Navy)//// Please let DAV know if you were awarded any of the medals listed below. This information will only be used for demographic purposes, and to potentially inform our members about issues related to their specific military experience. 4 4