Membership Application
SoCal Chapter - VHPA
Southern California Chapter - Vietnam Helicopter Pilots Association MEMBERSHIP APPLICATION
Dale Berry
27531 Cinnabar Rd
BARSTOW CA 92311-6106
Name:___________________________ VHPA Number_________________
Address:____________________________ City:______________________
State:___________ Zip:_________ Email:__________________________
Application: New______ Renewal_________ Change of address_____
Type of Membership: General_______ Associate_____
Annual Membership Dues:
General - $25.00 Associate - $30.00
Date:__________
It is necessary for General membership applicants to complete the Military Information section below.
Military Information
Branch of Service:_____________ Rank:________ Flight School Class
Number(s):____________ Dates of Military Service:________________
RVN Unit(s):____________________________
Location of unit(s)_______________________
Dates of RVN Service:___________________
RVN Duties:____________________________
Your Call Sign(s) (please list in order of preference):_______________
_________________________ __________________
Additional Comments:
The SoCal Chapter - VHPA is a California non-profit 501(c) 3 Veterans Organization whose goals and objectives follow those of the National VHPA Organization, e.g. fraternal and non-political, as implemented at the local chapter level.