1st Inf Crest 2nd Bn., 1st Inf. Regt. Membership Application

Section 1: Applicant Information

Last_______________ First_________________MI____ Address____________________________________ City: ________________ State_______ Zip__________

Home Ph_______________ Cell Ph_____________ Email_________________________ Nickname: ________ 2/1 Company: _____ Dates of service: MO/YR______ MO/YR______

May Section 1 information be included on our website Roster Company Page?   Yes    No Name only  Yes     No

Section 2: Personal Information (optional)

Date of Birth___________ Occupation_____________________ Name of Spouse________________ Enclosed DD-214 copy: Yes No Signature____________________________ Date: _________

Chapter Membership: 2/1 Chapter dues will be $5/year or $50 for lifetime membership for 2/1 veterans or associate members. Amounts less than $50 will be applied annually for as many years as the amount will cover. Any amount over $50 will be considered a donation to the chapter fund unless specified below. Amount sent $_____ Apply: yearly ___ lifetime ___ Apply amount over $50 to: General Chapter fund ___ Flower/Wreath fund ___ Bravo Company Kokomo Memorial Brick fund * ___
Chapter Meeting Hospitality Room ___ Americal Memorial/Monument fund ___

* The Bravo Brick fund provides for a memorial brick to be placed in the B 2/1 section of the Kokomo Memorial Garden during the opening ceremonies at the annual Kokomo, Indiana Veterans Reunion. Any member of B 2/1 is eligible for a brick upon passing. Engraved bricks are $25. The following in formation must be provided to order a brick. Veteran's Name ________________________ KIA ___ non-KIA ___ Date of Death _________ Years in Vietnam ___-____ non-KIA bricks will be inscribed with a CIB designation instead of KIA.

Please enclose required dues and/or donations made payable to Jesse J. Mendoza Sec/Treas. and mail or email this application to:
2nd Bn., 1st Inf. Regt. Chapter
1109 Burkett Cir.
Cameron, TX 76520
Attn: Secy/Treas
Email: eboney3851@att.net