Membership Application
Fill out the following application before printing. You may join any Chapter in the Oklahoma Department. Applications will be forwarded to the appropriate Chapter for processing. If you are uncertain of the nearest Chapter to your location, you may join as a "member at large" and Tulsa, Chapter 1 will contact you with location choices.
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I wish to join Blue Star Mothers Dads Associate
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Which Oklahoma Chapter (see note above) |
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First and Last Name |
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Street Address |
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City |
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State |
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Zip |
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Phone Number |
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Email Address |
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Military Service Member's Name (use extra lines if more than one service member) |
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Date of Birth |
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Relationship to Member |
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Branch of Service |
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APO/FPO Address |
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Where is this member stationed? |
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Military Service Member's Name |
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Date of Birth |
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Relationship to Member |
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Branch of Service |
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APO/FPO Address |
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Where is this member stationed? |
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Signature |
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Please print form and mail to:
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Be sure to include membership fee: |
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$10.00 Membership Fee |
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$10 Pin Fee (Optional) |
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Associate Membership (no fee at this time)
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For Administration Only
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Date application received: ______________________________ Paid: Check Cash Money Order Check/Money Order #: ______________________________ Total Amount Paid: ______________________________ Paid: ______________________________ Received by: ______________________________ Membership Card: Given Mailed Date: ______________________________ Pin: Given Mailed Date: ______________________________ Date Deposited into Account: ______________________________
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