MEMBERSHIP APPLICATION

DATE; _________________

L NAME: _________________________ F NAME_________________MI:_________

STREET ADDRESS:_____________________________________________

CITY: _____________________________ STATE: _________ ZIP: ______________

PHONE: ( _)______ _______________ DATE OF BIRTH: ___________________

E-MAIL ADDRESS: _____________________________________________________

Membership requirements; The applicant must have been awarded the Combat Infantry Badge as certified to by official notation on the applicants DD 214, Official Army Orders or other official documents. Applicant must attach a copy of such documentation to this enlistment (membership) application. Dues are $20.00 for two (2) years - $75.00 For a Life Membership. We do not have a one (1) year membership.

Date entered US Army: ________________ Date discharged or retired: ______________

CIB awarded for combat service during the following period(s). Check all that apply.

WW II ____ Korea: ____ Vietnam: ___ Grenada: ____Panama: ____Desert Storm: ___

Other: ________________

Combat unit that awarded the CIB(s): _________________________________________

I hereby apply for membership in the Combat Infantrymen’s Association, Inc. and certify I am eligible as explained above. A copy of the document verifying my eligibility is attached. Enclosed is my check __, Money Order __ for $________________.

SPONSOR: ____________________________________________________________

SIGNATURE: ______________________________________ DATE: ______________

MAIL THIS FORM AND DOCUMENTS TO;

NATIONAL ADJUTANT/FINANCE OFFICER

P O BOX 1234

WEST UNION, SC 29696

CIA NUMBER: CIA UNIT:

THIS IS THE ONLY AUTHORIZED ENLISTMENT APPLICATION FORM, DESTROY ALL OTHER FORMS. Revised November 9, 1999.

Back to CIA page