Ladies Auxiliary of FRA Application Form

 

Membership for the LA FRA is open to the spouse, daughters, stepdaughters, mother, grandmother, and granddaughters (not less than sixteen (16) years of age) of FRA members, and widows of those who were eligible to be members at the time of their death.

 

NAME:_______________________________________________________

 

ADDRESS: _____________________________________ APT:_________

 

DATE OF BIRTH: __________ SOCIAL SECURITY NO:_____________

 

HOME PHONE: ___________________

 

I am the: (Please check one of the following)

 

Spouse ____ Widow/Remarried ____ Mother ____ Grandmother ____

 

Sister ____ Daughter ____ Granddaughter ____ Stepdaughter ____

 

of (Serviceman's Name:) __________________________ Rate/Rank:_____

 

Service Branch (USN, USMC, USCG) ___________________

 

MEMBERSHIP PREFERENCE:

Unit Preference: LAFRA Unit 269

 

Applicants Signature: __________________________DATE: _______

 

Payment Options:

Cash ____ Check ____

DUES: ___ 1 Yr. $20.00

Proposed by: _________________________________ Member # ____________ Unit # ________

Verification of Eligibility

The above named Fleet Reservist is a member of the FRA Branch  269

The above named Fleet Reservist was eligible to be a member of the FRA Branch 269 at the time of death (Date) ______________

 

Unit Secretary: _________________________________ Date: ______________

 

Return Application to:

LAFRA  Unit 269