Northeast Florida Chapter Membership Application
Rank:
*First Name:  
MI:
*Last Name:  
Telephone:
email:
Spouse:
Address:
Address cont:
City:
State:
Zip:
   
  USMC: USMCR: Former Marine: USMC(Ret.): USMCR(Ret.): Date Ret: 
1st Marine division Service
  Company Bn Regt Date  
   
   
   

Engagements/Battles/Campaigns - 1st Marine Division
  Engagement Unit  
   
   
   

Engagements in Other Units
  Engagement Unit Date
 
 
 

Comments:

 

 

 You must be a member of the 1st Marine Division Association before officially joining the NE FL Chapter.
Please go to this website for an application: www.1stmarinedivisionassociation.org
Please complete and mail to the address in Oceanside, CA shown.

Dues $10.00 Per Year (Due by February 1st of each year)
Please send first years dues to:

Jim Gilleo
Treasurer, FMDA, NE Florida Chapter
1344 Domas Drive
Jacksonville, FL 32211-4805

Please make out the check to FMDA, NE FL Chapter.
Jim Gilleo can be contacted at 904.744.8684

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