Membership InformationHome/MembershipAssociate Membership Form Name Email Address Telephone Occupation Date of Birth: JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember 12345678910111213141516171819202122232425262728293031 2000199919981997199619951994199319921991199019891988198719861985198419831982198119801979197819771976197519741973197219711970196919681967196619651964196319621961196019591958195719561955195419531952195119501949194819471946194519441943194219411940193919381937193619351934193319321931193019291928192719261925192419231922192119201919191819171916191519141913191219111910190919081907190619051904190319021901 Declaration: I hereby apply for membership of the Dunedin Returned and Services’ Association and certify that the information given herein is correct. I undertake to abide by the Constitution and Rules of the RSA. I have never been expelled or rejected from membership of any other branch of the Returned and Services’ Association organisation.[acceptance] Returned Service Membership Form Name Email Address Telephone Occupation Date of Birth: JanuaryFebruaryMarchAprilMayJuneJulyAugustSeptemberOctoberNovemberDecember 12345678910111213141516171819202122232425262728293031 2000199919981997199619951994199319921991199019891988198719861985198419831982198119801979197819771976197519741973197219711970196919681967196619651964196319621961196019591958195719561955195419531952195119501949194819471946194519441943194219411940193919381937193619351934193319321931193019291928192719261925192419231922192119201919191819171916191519141913191219111910190919081907190619051904190319021901 Marital StatusSingleMarried Spouse / Partner’s Name Branch Service Number Service NavyArmyAir ForceOther Unit(s) Length of service Rank Theatres of Service and Dates Medals and Awards Any other Relevant Service Information Are you receiving any financial assistance from War Pension Services? YesNo Would you like the RSA Welfare Officer to contact you? YesNo Declaration: I hereby apply for membership of the Dunedin Returned and Services’ Association and certify that the information given herein is correct. I undertake to abide by the Constitution and Rules of the RSA. I have never been expelled or rejected from membership of any other branch of the Returned and Services’ Association organisation.[acceptance]
