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:

Mastercard ____ Visa ____ Check ____

Credit Card # ______________________ Exp Date: _____________

DUES: ___ 1 Yr. $15.00

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 Branch 269