VIETNAM VETERANS of ECHO COMPANY

2nd BN 3rd MARINES (April 1965-October 1969)

ENROLLMENT FORM

Make $10.00 Dues Check Payable to “VIETNAM VETERANS of ECHO CO. 2/3”

And Mail To:

ELLER, John L.

167 Leslie Drive

HubertNC

28539

16625-0018

16625-0018

NAME:  ___________________________________________________________________

ADDRESS:________________________________________________________________

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PHONE #:________________________________________________________________

E-MAIL:________________________________________________________________

D.O.B.:________________________________________________________________

RANK & DATES w/ECHO:  ___________________________________________________________

PLATOON:_________________________________________________________________

HONORS (Silver/Bronze Stars, Purple Heart, etc. and Operation(s) where awarded if known)

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SPOUSE:_________________________________________________________________

ANNIVERSARY: ____________________________________________________________

COMMENTS: _______________________________________________________________

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