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CITRUS COUNTY VETERANS COALITION, INC.

Regular or Associate Member

$10 Annual Donation or

$25 for 3 years.

Lifetime Member or Corporate

$100 Donation

Lifetime Veterans Organization

$50 Donation

CCVC Membership Application

Please submit proof of military service or membership in a military organization (DD 214, VFW, American Legion, etc.).


1. Fill out this form online    2. Print it    3. Mail to:


Citrus County Veterans Coalition, P.O. Box 851, Inverness, FL 34451


NOTE:  Be sure to include a self-addressed, stamped envelope in order to receive your membership card.

FIRST NAME

LAST NAME

ADDRESS

CITY

STATE

ZIP CODE

PHONE NUMBER

BRANCH OF SERVICE

DATES OF SERVICE

VETERANS GROUP AFFILIATIONS

EMAIL

HOW DID YOU HEAR ABOUT US?