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Membership Renewal
DINFOS Alumni Association |
Defense Information School Alumni Association
P. 0. Box 269295
Indianapolis, IN 46216-6200
(317) 546-1743 Fax: (317) 568-1439
Website:
www.dinfosalum.org
Name:_________________________________________________________________
Membership #___________
Date_________________
Please renew my membership as follows:
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__1 year ($25 for E-5 or above, civilian, or
retired) |
___ Life ($250 for age 39 and below)
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__1 year ($10 for E-4 or below) |
___ Life ($200 for age 40 through 59)
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__3 years ($60 for E-5 or above, civilian, or
retired) |
___ Life ($150 for age 60 and over)
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__3 years ($25 for E-4 or below) |
Date of birth: __________________ |
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Records
Verification
Full Name:
__________________________________________________________________________
Address:
___________________________________________________________________________
City: _______________________________________ State:_______ Zip:
_____________________
Home Phone: (
)___________________ Business Phone: (
)_____________________
Fax Number: (
)________________
E-mail address:______________________________________________________
Mail completed form with payment to:
DINFOS Alumni Association
P. 0. Box 269295
Indianapolis, Indiana
46216-6200
For Office Use Only
( )
Administration ( ) Treasurer (
) Membership
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