Membership Application

New Membership Application - Please Pass This Along to Prospective Members

5th INFANTRY REGIMENT ASSOCIATION

Name ______________________________________  (Name of spouse) ___________________________

Street __________________________________________________________________________________

City ________________________________  State ________________________  Zip ______________

Telephone  ________________________          Email Address  _____________________________

  Unit Served With in the 5th Infantry or  1/5th (Mech)  __________________________________

Dates of Service ____________________

Type of Membership: Regular____  Active Duty____ Associates____

How did you hear about the Chapter? _________________________________________________

DUES: Active duty $5.00 Per Year * Annual - $15.00  *  Two Years - 25.00   *     *  5 years - $60.00
  Lifetime (65 and older) $100.00 (Age 50-64) $150 (Up to Age 49) $200 *

 Please Make Checks payable to: 5th Infantry Regiment Assn. and send to:
Tom Frame,  460 Center School Road. Perkasie, PA 18944

Phone 215-514-6613

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