US Army Medical Command Japan

ASSOCIATION

"An Association Of Life Savers And Care Givers That Served In Post world War II"

Dear Sir:

Please accept my application for the USAMCJ Association. The information listed below is submitted to verify my qualification to join your organization. I will send a check or a money order to pay for my selected category of membership. I understand that ALL Membership will expire 31 December of last year paid.

Please Check Type of Membership

  Regular 1 yr $10.00

  Regular 2 yrs $20.00

   

  Associate 1 yr  $5.00

  Associate 2 yrs $10.00

 

Type in information below and send it the address at bottom of page.

Name (last - first - mi)
Street # and Name             
                             City     State     Zip + 4 
Home Phone #              E-mail Address  
 

If you are the spouse, widow/widower, or child of someone that served a medical mission in Post WWII & wish to join our Association, check here

If the unit you, your spouse, or parent served in is not listed below, enter it here

 

If retired from the military, please provide the following information:

  • Month/Year of Retirement

  • Grade/Rank at Retirement

  • Corps/Branch

Tell us a little about yourself. Current status (i.e. current employment, hobbies, volunteer services, type of employment, etc.

If retired, what type of work did you do? (Other than military)

 

Patients at any of the medical facilities also qualify

Print this Application, Then mail Check or Money Order To:

USAMCJ Association

Secretary & Treasurer

Attn: Charles W.S. Jezycki

1918 Shurtleff Avenue

Napa, CA 94559