MILLENNIUM CHAPTER

Please print and mail this form.
Membership Application and Dues Payment

Membership Information: The following information is requested to verify membership eligibility.

Your name _____________________________________Phone _____________

Address __________________________________________________________

City _______________________________ State _____ Zip Code ___________

Spouse ____________________ E-Mail address _____________________  Date of Birth _________

Your Relation to Veteran _______________________________________________
( Son, Daughter, Grandchild, Nephew, Niece, Self (“Veteran”) etc.

Veteran's Name _______________________________________World War (I or II) _______

Rainbow Division Unit _________________________________________________
(Company/Regiment, Battery, Headquarters, etc.)

Was veteran a member of the RDV Association ? __________ What Chapter ?______

Is the veteran a current member of the Foundation? _______ What Chapter?_________

Dues Payment: RDV Memorial Foundation dues are $10.00/year. Millennium Chapter dues are $5.00/year.
TOTAL:  $15.00/year.
If you are a Life Member of RDVA or pay Foundation  dues through another chapter, you pay only the Millennium Chapter dues.

Foundation Dues: $______________ If you pay Foundation dues through another chapter,
please list Chapter: ____________________________

Millennium Chapter Dues: $ ________ 
Gift/Donation to Chapter:   $ ________  Make check payable to: RDV MILLENNIUM CHAPTER

Contribution to Memorial Foundation: OPTIONS:
“Operating” Fund; “Endowment” Fund; “Scholarship Operating” Fund; “Scholarship Endowment” Fund.
If the donation is to be “IN HONOR OF” or “IN MEMORY OF” please provide name and family contact & address.

                                             $________ Make check payable to: RDV MEMORIAL FOUNDATION
Thank you very much for your interest, support and encouragement!
TOTAL $ ________________ Mail check(s) and this form to:

Mrs. Suellen McDaniel, Secretary Millennium Chapter
1400 Knolls Drive
Newton, NC 28658-9452
Telephone:  (828) 464-1466

If you need assistance in determining the veteran’s Rainbow Division Unit or have any other questions concerning the completion of this form, please contact at the address above; or, Mrs. Suellen McDaniel, RDVMF National Membership Officer (e-mail: millennium@rainbowvets.org or use the Millennium Chapter e-mail form).