Membership Form
Name:_________________________________________ Rank:_____________
Home Address:________________________________
State:______________ Zip:________________
Home Phone:_____________________________
Cell Phone:_______________________________
E-Mail Address (Required):_____________________________
Total years of military service: ___________
Years in the 42nd Infantry Division: ________
Major Unit: __________________________________________
Dues Schedule: One Year: $25.00 ______
Lifetime: Age Rate Age Rate
80 and over $75.00 61 to 65 $185.00
76 to 79 $105.00 56 to 60 $190.00
71 to 75 $130.00 51 to 55 $210.00
66 to 70 $180.00 50 and below $220.00
Please make checks out to: “42 Div Rainbow Assn”