Annual Dues are $25.00 and are due no later than January 31st, 2010 to remain on the mailing list for the Newsletter and other information.

For Membership: NEW RENEWAL (please circle one)

Name, Last ________________________First___________________Middle Initial____

Highest Rank Held __________________Spouse's First Name____________________

Mailing Address_________________________________________________________

City______________________________State______Zip Code__________-_______

Home Phone_______________________E-Mail address ________________________

Squadron Served with at Pleiku_____________________________________________

Dates Served at Pleiku (month / year) __________________ to ___________________

I approve of my name, unit, and e-mail address being listed on the "Contact a Member" web page. (check here) [ ]

Mail the above information with a check for $25 to:

Pleiku Air Base Association
P.O. Box 552
St. Clairsville, OH 43950-0552