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Please PRINT this form and MAIL with check to:

SPECIAL FORCES ASSOCIATION
Jan Roush, Treasurer
Special Forces Association - Chapter 39
1833 Max Road
Pearland, Texas 77581
(832) 467-1106

MEMBERSHIP APPLICATION

MEMBERSHIP TYPE
___ Associate Membership
___ General Membership
___ Decade Membership
SSN _______________________
Telephone (__) _________________
___________________________________________
Last First

MI

___________________________________________
Mailing Address
___________________________________________
City

State

Zip (PLUS-FOUR)
___________________________________________
E-mail Address



Awarded----Prefix___"3" ___Suffix "S", 5G, 18/180 MOS on ________________________________

Total years and months of service to Special Forces and/or related units _____Years _____Months

SF ASSIGNMENTS
UNITS INCLUSIVE DATES UNITS INCLUSIVE DATES
____________________________________________
____________________________________________
____________________________________________
_____________________________________________
_____________________________________________
_____________________________________________





MEMBERSHIP QUALIFICATIONS

1. All units officially listed on the 1st SF lineage certificate are acceptable for membership. Also acceptable are service in the Office of Strategic Services, Ranger units, Partisan Forces Korea, 110th Recon, and school assignments requiring a PCS from any SF unit. (Must be in conjunction with Special Forces Duty.)

2. DECADE MEMBER: Decade membership may be granted to a person who is or has been a member of the US Army Special Forces, including the US Army Reserve, and the National Guard for a minimum of ten years, who has been awarded a prefix "3" or Suffix "S", 5G, 18/180 series and, if discharged, received an Honorable Discharge. Decade membership may also be granted to members who have a combination of 10 years Special Forces duty and Special Forces Association membership. (Documents required.)

3. GENERAL MEMBER: Membership may be granted to a person who is or has been a member of the US Army Special Forces, including the US Army Reserve and the National Guard, who has been awarded a prefix"3" or the suffix "S", 5G, 18/180 series MOS and, if discharged, received an Honorable Discharge. (Documents required.)

4. ASSOCIATE MEMBER: Associate membership may be granted to any person not qualified as above, but who has contributed significantly to the support of Special Forces, or its lineage, in the accomplishment of its mission. Applications for Associated membership are subject to the approval of the Membership Committee. Proof of contribution to Special Forces must accompany the application.

AUTHORITY FOR RELEASE OF INFORMATION AND RECORDS

I hereby authorize and consent to the release of information and records bearing on my military service, to the Special Forces Association. The information will be used for the purpose of determining my qualifications for membership. I further certify that the execution of this form is voluntary and shall be valid for one year after my signing.

Signature: ______________________________________________________________________ Date:_______________

Witness: _______________________________________________________________________ Date:_______________

I understand that Special Forces Association membership entitles me to the rights and privileges specified in the provisions of the Special Forces Association Constitution. Enclosed is a check or money order for $40.00 payable to the SFA for the initiation fee ($10.00) and first year dues ($30.00). To maintain my membership, I will pay the annual dues of $30.00 no later than January 31 each year. If paid after 31 January, I must pay an additional $5.00 reinstatement fee (total of $35.00). Lifetime membership is available to members under 65 in good standing at a cost of $400.00. All qualified new members under 65 must pay a total of $440.00 for Lifetime membership. Lifetime membership for members 65 and over in good standing is $280.00. Qualified new members over 65 must pay a total of $320.00 for Lifetime membership

Revised Feb 2007