America's Oldest Army Division

New Members

First Name:

Middle:

Last:

SSN:

(last 4 digits)

Street:

Spouse's Name:

City:

State:

Zip Code:

Country:

Date of Birth:

Home Phone:

Work Phone:

Fax:

E-Mail Address:

Status:

Dates of Service:

Active Duty: WWII

Korean War

Viet Nam

Desert Storm

Kosovo

Iraq

Afghanistan

Home Land Security

Other Conflict(s)/Campaign(s):

Units of Affiliation:

(Indicate all units that you have served with)

Membership Type:

Number of Years Renewal:

Highest Rank Held:

Your MOS:

Wartime Service:

Place entered on Active Duty:

Training Center(s):

POW:

Where:

Wounded:

Any Additional information you wish to add (ie: Decorations, awards, etc.):

Note any special events or actions which you may recall and why:

List any members in your squad, platoon, and company and their location (if known):

Place of Discharge:

Thank you for becoming a member of the 28th Infantry Division Association. You should receive your membership card in the mail in 4 to 6 weeks. We also have Life Time Memberships available. Please email us at: info@28thinfantrydivisionassoc.org for more information about our Life Time Memberships.