______________________________________________________________________________

Applicant’s LAST Name           First      (I)                                First name of spouse

______________________________________________________________________________

1^st Mailing Address                                            City                              St         Zip

___________________________/________________________/__________________________

Home Ph#                                            Cell #                                                   Email

Referred By:_____________________

SMART is a Veterans Organization 501 (c-19); and REQUIRED to have the following information.

Branch of Svc_________ Yr Entered Svc__________; Yr Svc Ended_______________

New Member Badge comes with Packet;  Spouse Badge may be purchased for $7.50

Member Preferred 1^st Name:_______________________ Optional Info:___________________

Spouse Preferred 1^st Name:________________________ Optional Info:___________________

MEMBERSHIP FEES: Check Appropriate Category

(1) Regular Membership Fee: $15 New Membership Packet + $45 annual dues = $60

With Spouse Badge $67.50

 Please indicate your status: Active Duty (  ); Drilling Reserve or NG (  )

 Service Retired with ID card (  ) Medal of Honor Recipient (  )

(2a) Associate Membership Fee: $15 New Membership Packet + $30 annual dues = $45 

With Spouse Badge $52.50

Please indicate your status: Former POW (  ); Veteran with 40% disability service connected (  )

Widow / Widower of person eligible for Regular Membership (  )

(2b) Associate Spouse Fee: $30 annually (New Membership Packet fee waived if spouse is already a

SMART Member)  List SMART Spouse Member #__________

With Badge $37.50                   

(3) Canadian, NATO / SEATO Membership Fee: $20 New Membership Packet + $50 annual dues = $70;
With Spouse Badge $77.50

(4) Family Membership Fee: $15 New Membership Packet + $65 annual dues = $80

NOTE: Both Parties must meet eligibility requirements and INDIVIDUAL application must be

submitted.

*** Most Mail forwarding Services DO NOT forward 3^rd class mail - If you desire 1st class mailings of the TRAVELER, please add $10.00 per year with your payment. .

I certify with Honor the INFORMATION I have provided is true and correct

Applicant Signature_______________________________________ Date____________________

6/1/2009