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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: ___________________________________________ State: ____ Zip: ____________
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
7600 E. 130th Court
Grandview, Missouri 64030-2718
Visit us on-line at: usmcdisbursers.com
(MCDA App 1-07 Rev 06/08)