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.
One-year membership dues are $20.00. 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.
ORGANIZATION (USAFSS/ESC/AFIC/AIA/AFISRA/25th AF)
LAST ASSIGNMENT _____________________________
Inclusive years of service ____/_________ to _____/_________
OLD ADDRESS (For address change only)
Last Name _____________________ First Name _________________ MI.______
City ________________________, State ___________________ Zip _________
Yearly Memberships are $20.00
Life memberships are based on your current age as follows: