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Freedom Through Vigilance Association

PRIVACY ACT STATEMENT: The authority to request this information is contained in Public Law 86-36 and Executive Order 12036. The principal purpose of the information is to establish a mailing list for membership rosters containing the name, address and telephone number of all members of the association periodically. Furnishing the information is voluntary; failure to provide the requested information will result in your not being listed. Your signature below* indicates that you have read and understand the above.

*SIGNATURE _____________________________________________


One-year membership dues are $15.00. Make your check or money order payable to the FREEDOM THROUGH VIGILANCE ASSOCIATION, fill out this application and mail it to: Freedom Through Vigilance Association, P.O. Box 691616, San Antonio, Texas 78269-1616.

____ NEW MEMBERSHIP ____ RENEWAL ___ CHANGE OF ADDRESS


Last Name _____________________ First Name _________________ MI.______

Grade/Rank (optional) __________    Retired? (optional)   Y  /  N

Phone Number ________________________________________

Address ______________________________________________________________

City ________________________, State ___________________ Zip ________-_____

E-Mail Address _____________________________________   HAM Call Sign _________

ORGANIZATION (USAFSS/ESC/AFIC/AIA/AF ISR Agency) AND YEAR OF LAST 

ASSIGNMENT _____________________________


OLD ADDRESS (For address change only)

Last Name _____________________ First Name _________________ MI.______

Address ______________________________________________________________

City ________________________, State ___________________ Zip _________


Yearly Memberships are $15.00

Life memberships are based on your current age as follows:

___ 76 and over ............... $55 ___ 71-75 ...................... $75
___ 66-70 ...................... $95 ___ 61-65 ..................... $140
___ 56-60 ..................... $150 ___ 51-55 ..................... $165
___ 46-50 ..................... $180 ___ 41-45 ..................... $200
___ 36-40 ..................... $215 ___ 31-35 ..................... $230
___ 30 and under............... $245

 

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Our mailing address is: To E-mail the Freedom Through Vigilance Association,
select one of the below:

Freedom Through Vigilance Association
PO Box 691616
San Antonio, TX 78269-1616

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