Membership Application DINFOS Alumni Association

Name (Last)________________________  (First)______________________________ (MI)______

Address_________________________________  City_______________ State____ Zip_________

E-mail _________________________________ Home Phone (___)__________ FAX (___)________

Please send Alumni Association Information to me via: (Check all that apply)

   ___ Mail    ___ E-mail    ___ FAX

School Affiliation: (Check all that apply)

   ___ Army Information School, Carlisle Barracks, PA 
   ___ Air Force Public Information School, Craig AFB, AL 
   ___ Navy Journalist School, Great Lakes Naval Station, IL 
   ___ Armed Forces Information School, Carlisle Barracks, PA 
   ___ Armed Forces Information School, Ft. Slocum, NY 
   ___ Army Information School, Ft. Slocum, NY 
   ___ Defense Information School, Ft. Benjamin Harrison, IN 
   ___ Defense Information School, Ft. George G. Meade, MD

What was your status at any or all of the above institutions? (Check all that apply)

   ___ Graduate   ___ Staff/Faculty Member   ___ Currently enrolled ___Friend of The School

I am applying for the following membership:

___ 1 year ($25 for E-5 or above or retired for 1 year) ___ Life ($250 for age 39 and below)
___ 1 year ($10 for E-4 or below) For those currently on active duty ___ Life ($200 for age 40 through 59) 
___ 3 years ($60 for E-4 or above or retired for 3 years) ___ Life ($150 for age 60 and over) 
___ 3 years ($25 for E-3 or below) 

                    Date of birth: ____________________

Signature ___________________________________________________ Date________________________
Enclose check or money order payable to DINFOS Alumni Association and mail to:
DINFOS Alumni Association Membership Committee, P.O. Box 269295, Indianapolis, IN 46216-6200

For Committee use: $_______Dues Paid. Membership #___________ Date Issued _______
http://dinfosalum.org

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