-------Please Print out the form below and send it to the address Listed------

9th Infantry Division Society  – “Old Reliables”

Membership Application and Change of Postal or E-mail Address Form

Last Name:                                          First Name, M.I.:                    

Nick Name:                                                  Spouses Name:                                     

Mailing/Street Address:                                                                                

City:                                             State:                          Zip Code:                            

Home Phone Number w/Area Code:                                                         

Work Phone Number w/Area Code:                                                                   

Cell Phone Number w/Area Code:                                                                   

Email Address:                                                                                          

Unit Assignment(s) in 9^th ID:                                                                      

Dates of Service w/Unit:                                                                          

Comments About Your Unit/Service:                                                                                                                                                                        

Membership Dues (check one):                One year - $15               __  Three Years - $35                __    Lifetime - $150                           __

If you were awarded the Medal of Honor while serving with the 9^th Infantry Division or are classified by the VA as 80% or more disabled,

you are not required to pay dues to become a member of the 9^th Infantry Division Society – “Old Reliables”.

If you fit into one of these two categories and choose not to pay dues please select NO DUES here            .

I wish to make a donation to the 9^th Infantry Division Society – Old Reliables General Fund of  $                 .  

Make all checks or money orders payable to 9^th Infantry Division Society.

Mail to:         9th Infantry Division Society,  PO Box 94,  Falls of Rough, KY   40119

++++++++++++++++++++FOR CHANGE OF ADDRESS++++++++++++++++++++

Name:________________________________________________________________

New Mailing/Street Address:                                                                                          

City:                                                        State:                                Zip Code:                         

New Home Phone:                                           New Cell Phone:                                    

Thank You & "WELCOME HOME"