MEMBERSHIP APPLICATION

Applicant’s Name: Date:___/___/____

Mailing Address:

Marine Corps League Detachment Affiliation:

Are you an American Motorcyclist Association Member?: If yes, AMA Membership #:

Home Phone:

Cell Phone:

E-mail Address:

Membership Type (Fill in One):

Marine Veteran: mm/yy – mm/yy

Marine Combat Veteran: mm/yy – mm/yy

Corpsman : mm/yy – mm/yy

Chaplain: mm/yy – mm/yy

Type of Motorcycle Participation: (e.g., Rider, Passenger, or Chase Vehicle)

Complete, include a copy of your DD214, and mail to:

Marines the Few the Proud - 42 Central Pkwy., Merrick, N.Y. 11566

Sponsor: (Marines the Few the Proud Member’s Name)

Membership Approved on: ___/___/___