VVAA NSW Membership Form
Vietnam Veterans Association of Australia - NSW

 

Vietnam Veterans Association of Australia - NSW Branch
Proxy Form

 

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This application must be accompanied by the payment of the $20.00 subscription to
BSB 062-591, Bank Account 10074281 with your initials and family name in the remarks.

When completed this form will be forwarded to the State Secretary who will match your details to the subscription payment and forward to the appropriate Sub-Branch Secretary who will then contact you.

The Sub-Branch Secretary will require you to provide evidence of service or status.

Membership Info

Initial Renewal Transfer

Transfer From (If Applicable)

Veteran Partner Child

Ordinary Life Associate

Veteran Name

Given Names

Family Name

Post-Nominals

Date of Birth

Residential Address

Building/Property/Apartment

Street

Suburb/Town

State Post Code

[If Partner or Child, enter your details as Next of Kin and the Veteran's Name and Service information in the spaces provided]

Postal Address (if different)

PO Box

Suburb/Town

State Post Code

Phone & eMail

Home Phone

Mobile

eMail

NOK Name

Given Names

Family Name

Relationship

NOK Address (if different)

Street or PO Box

Suburb/Town

State Post Code

Service Information

Service Number

Branch of Service
RAN  Army  RAAF*nbsp; Other

Service (if Other)

Enlistment

Enlistment Date

Discharge/Retirement Date

Discharge Certificate

War Service 1

Area

Unit

From Date

To Date

War Service 2

Area

Unit

From Date

To Date

Optional Information

DVA File Number

Pension Rate

  

 
 
 
Vietnam Veterans Association of Australia - NSW Branch ABN 43478199853
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