Membership Verification

All information you provide is confidential and will not be released to anyone outside the ACVVC. This information will be used for membership/address verification only.

Name:                     

Address:                

City:                        

State/Province:    

ZIP Code          :      -  

Country:                

Email:                     

Phone:                   

Unit with the 11th ACR?
1. Troop/CoSquadron
2. Troop/CoSquadron
2. Troop/CoSquadron
 

When?
1. FROM Date Month Year

     To:        Date Month Year

2. FROM Date Month Year

     To:        Date Month Year

3. FROM Date Month Year

     To:        Date Month Year

Do you want your E-mail address posted on the Locator Page? Yes No

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