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MARINE CORPS DISBURSING
ASSOCIATION |
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MEMBERSHIP APPLICATION
YES! I want to be a voting member
of the MCDA. My two-year membership fee of
$25.00 is
enclosed.
DATE:
______________________
Name:
(First)_____________________(MI)____(Last)___________________(Suffix)_____
Address: __________________________________________________________
__________________________________________________________
City:
Phone Number: (_____)_____-____________
Cell
Phone:
(_____)_____-____________
Email
Address: ________________________________________________________
Eligibility:
(Check all that apply) Status:
(Check one) Rank:
_____
Marine Disbursing _____
Retired Marine _____
_____
Direct Disbursing Support _____
Active Duty Marine _____
_____
Spouse/Significant Other _____
Former Marine _____
_____
Descendent _____
Veteran/Service ________________
_____ Civilian
Dates of
Military Service: From/To ________________ (Used to identify combat veteran
status.)
Complete a
separate application for each member being enrolled. Application form may
be photocopied or just send a letter with the above information for each applicant
and the appropriate fee(s).
Make checks payable to: MCDA.
Mail your
completed application and fee(s) to:
Michael Thiry, Treasurer
MCDA
Visit us on-line at: usmcdisbursers.com
(MCDA App 1-07 Rev 09/10)