Michigan
Association of County Veterans Counselors Membership
Application
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Name:__________________________________ County:_____________________________
Title:___________________________________ Date:______________________________
Office
Address:___________________________ Telephone:__________________________
Fax:___________________________________ E-mail
address:______________________
Office
Hours/Days of Operation:______________________________________________________
------------------------------------ OTHER
OPTIONAL INFORMATION ---------------------------------------
Public
law under which your office operates:
P.A.
77_____ P.A.
139_____ P.A.
192_____ P.A.
214_____
Other
(please specify)________________________________________________
Military
Service (if any)Branch:_____________ Entry
Date:_______________ Discharge Date______________
ANNUAL
DUES ARE $25.00 FOR MACVC
AND $30.00 FOR NATIONAL ASSOCIATION OF COUNTY VETERANS
SERVICE OFFICERS
($55.00 TOTAL).
Print and mail to:
Tina Roff, Treasurer
171 Dawson St.
Sandusky, MI 48471
Updated
January 2003 |